The designation from the condition’s oldest patient organization is awarded to programs with the infrastructure and experience needed to provide high-quality care to people with pulmonary hypertension, a type of high blood pressure that occurs in arteries of the lungs.

Pulmonary hypertension can make it difficult for blood to circulate through the lungs, forcing the heart to work harder. In severe cases, the condition can lead to heart failure. People with pulmonary hypertension often need care from several specialists.

The Cedars-Sinai Pulmonary Hypertension Clinic includes six physicians and one nurse practitioner. The pulmonary hypertension program combines cardiology and pulmonology, which allows patients to access multidisciplinary care from experts in the disease. Providers care for more than 250 patients each year and address multiple aspects of the disease, including diagnosis, medication management, symptom control and disease progression.

“At Cedars-Sinai, pulmonary hypertension specialists collaborate with colleagues in rheumatology, congenital heart disease, critical care medicine, lung transplantation and other specialties to create treatment plans tailored to patients,” said Yuri Matusov, MD, assistant professor of Medicine at Cedars-Sinai. “We are proud to care for an extraordinarily diverse patient population, some of whom come from very far away for their care.”

The association noted several outstanding aspects of the Cedars-Sinai Pulmonary Hypertension Clinic including:

• A team that collaborates and provides timely evaluation and management of people who are hospitalized and continues to provide consistent care when they leave the hospital.
• Monthly conferences with specialists in the Southern California region that allow for the review of complex pulmonary hypertension cases, knowledge-sharing and regional care coordination.
• For people with advanced disease, access to top-notch heart, lung and thoracic transplant programs.
• A research program led by doctors investigating potential treatments.

“We are honored for our clinic to have received this designation, the highest recognition available to pulmonary hypertension programs in the United States,” said Dael Geft, MD, assistant professor of Cardiology in the Smidt Heart Institute at Cedars-Sinai. “Ultimately, the greatest reward is helping our patients live longer, healthier and more fulfilling lives.”

Read more on the Cedars-Sinai Newsroom: Unique Cell-Based Approach for Pulmonary Arterial Hypertension Shown to Be Safe

La terapia, denominada deramiocel, es el primer tratamiento que ha demostrado preservar la función del corazón en la distrofia muscular de Duchenne, una enfermedad hereditaria poco frecuente que debilita progresivamente los músculos de todo el cuerpo. La insuficiencia cardíaca causada por esta enfermedad es una de las principales causas de muerte prematura.

“Después de más de dos décadas de trabajo, hemos demostrado que deramiocel puede ralentizar o incluso detener no solo la pérdida de la función de las extremidades superiores, sino también la progresión de la insuficiencia cardíaca en niños y jóvenes con Duchenne”, afirmó Eduardo Marbán, MD, PhD, director ejecutivo del Smidt Heart Institute de Cedars-Sinai y autor principal del estudio. Deramiocel se basa en los descubrimientos realizados por Marbán.

La distrofia muscular de Duchenne afecta principalmente a los niños porque es causada por una mutación en el cromosoma X. Los niños que nacen con esta mutación desarrollan debilidad muscular progresiva en todo el cuerpo, incluido el corazón. Con el tiempo, presentan dificultades para correr, saltar, andar en bicicleta y realizar otras actividades cotidianas, hasta perder la capacidad de caminar. Actualmente no existe una cura.

Resultados Positivos

El estudio aleatorizado y doble ciego, denominado HOPE-3, comparó deramiocel con un placebo en 106 participantes, de entre 10 y 22 años, con enfermedad avanzada. Cada tres meses, durante un año, los participantes recibieron una infusión intravenosa de deramiocel o placebo.

Los resultados mostraron que la terapia redujo en 54% el deterioro de la musculatura esquelética y ralentizó en 91% la progresión de la disfunción cardíaca. En los pacientes diagnosticados con miocardiopatía, una afección que reduce la capacidad del corazón para bombear sangre, quienes recibieron deramiocel mantuvieron completamente la función cardíaca o incluso mostraron una ligera mejoría.

“Los beneficios observados podrían traducirse en mejoras importantes en la calidad de vida de las personas con Duchenne avanzado”, señaló Craig McDonald, MD, profesor distinguido de Medicina Física y Rehabilitación y Pediatría en UC Davis Health e investigador principal nacional del estudio HOPE-3. “Si los jóvenes conservan la función de las extremidades superiores, podrán mantener actividades esenciales como alimentarse por sí mismos. Además, los beneficios para el corazón podrían reducir la mortalidad”.

Décadas de Investigación

Esta posible terapia adopta un enfoque diferente al de otros tratamientos estudiados para la distrofia muscular de Duchenne. Deramiocel se elabora a partir de células obtenidas de corazones sanos donados para trasplante que finalmente no pudieron utilizarse y que, de otro modo, habrían sido descartados.

La investigación comenzó en 2004, cuando Marbán aisló por primera vez una población de células progenitoras cardíacas conocidas como células derivadas de cardioesferas (cardiosphere-derived cells). Los primeros estudios clínicos con estas células se realizaron en Cedars-Sinai en pacientes que habían sobrevivido a un infarto.

Los resultados publicados en 2012 demostraron que las infusiones celulares regeneraban el músculo cardíaco dañado tras un infarto. Desde entonces, el equipo de Marbán ha investigado el potencial terapéutico de estas células en otras enfermedades y ha realizado descubrimientos clave, entre ellos que las células derivadas de cardioesferas secretan vesículas con moléculas de ARN que ayudan a reparar los tejidos del organismo.

En 2011, Catherine Jayasuriya, madre de un niño con distrofia muscular de Duchenne y defensora de los pacientes, convenció a Marbán de ampliar sus investigaciones desde la reparación del corazón tras un infarto hacia el estudio de esta enfermedad genética. La recaudación de fondos liderada por Jayasuriya proporcionó el financiamiento inicial que permitió al laboratorio de Marbán poner en marcha las primeras investigaciones. Posteriormente, la empresa biotecnológica Capricor Therapeutics obtuvo la licencia de la tecnología desarrollada por Marbán y continuó el trabajo mediante ensayos clínicos para evaluar la seguridad y eficacia de deramiocel.

“Este es el primer ensayo clínico de fase III que demuestra que una terapia celular es eficaz para tratar una enfermedad genética o cualquier tipo de enfermedad cardíaca”, afirmó Marbán, quien ocupa la cátedra Mark S. Siegel Family Foundation Distinguished Professor.

Los investigadores tienen previsto continuar estudiando los efectos terapéuticos de deramiocel, incluido su posible uso para tratar otras enfermedades con importantes necesidades médicas no cubiertas.

“Estos resultados representan un avance importante para las terapias celulares, impulsado por la incansable labor científica del Dr. Marbán y su equipo”, afirmó Shlomo Melmed, MB, ChB, vicepresidente ejecutivo de Asuntos Académicos y decano de la Facultad de Medicina de Cedars-Sinai.

Autores: La lista completa de investigadores del estudio HOPE-3 puede consultarse en el apéndice suplementario del artículo.

Financiamiento: El ensayo HOPE-3 fue financiado por Capricor Therapeutics Inc.

Divulgación de conflictos de interés: Eduardo Marbán, MD, PhD, es inventor de patentes licenciadas a Capricor Therapeutics Inc. y posee una participación accionaria como fundador de la compañía.

Cedars-Sinai Health Sciences University está impulsando investigaciones innovadoras y formando a los futuros líderes en medicina, ciencias biomédicas y ciencias de la salud afines. Más información sobre la universidad.

The therapy, called deramiocel, is the first treatment shown to preserve heart function in Duchenne muscular dystrophy, a rare inherited disease that progressively weakens muscles throughout the body. Heart failure caused by Duchenne commonly leads to early death.

“After more than two decades of hard work, we have demonstrated that deramiocel can slow or even halt not only the loss of upper limb function, but also progression of heart failure in boys and young men with Duchenne,” said Eduardo Marbán, MD, PhD, executive director of the Smidt Heart Institute at Cedars-Sinai and senior author of the study. Deramiocel is based on Marbán’s discoveries.

Duchenne muscular dystrophy primarily affects boys because it is caused by a mutation on the X chromosome. Children born with this mutation develop muscle weakness throughout the body, including in the heart. As they grow older, these children have difficulty running, jumping, pedaling a bicycle and doing other activities, and eventually lose the ability to walk. There is no known cure.

Positive Findings

The randomized, double-blind study, called the HOPE-3 trial, compared deramiocel to placebo in 106 participants ages 10 to 22 with advanced disease. Every three months for one year, participants received an IV drip of either deramiocel or a placebo.

Results showed that the therapy slowed weakening of skeletal muscles by 54% and slowed heart dysfunction by 91%. In patients diagnosed with a condition called cardiomyopathy, which impedes the heart’s ability to pump blood, those who received deramiocel showed full preservation or slight improvement of heart function.

“The benefits we observed could mean important improvements in quality of life in people with advanced Duchenne,” said Craig McDonald, MD, distinguished professor of Physical Medicine & Rehabilitation and Pediatrics at UC Davis Health and national principal investigator of HOPE-3. “If young people maintain their upper limb function, it will help preserve their ability to do normal activities, such as feeding themselves. The heart benefits could reduce mortality.”

Decades in the Making

The potential therapy takes a different approach from other therapies that have been studied for Duchenne. Deramiocel is made from cells taken from healthy hearts donated for transplantation but unable to be used as such and that would otherwise be discarded. The work began in 2004, when Marbán first isolated a population of heart progenitor cells called cardiosphere-derived cells. The first clinical studies of cardiosphere-derived cells were performed at Cedars-Sinai, on patients who had survived heart attacks.

Results published in 2012 showed that the cell infusions regenerated heart muscle damaged by heart attack. Ever since, Marbán’s team has been studying the broader therapeutic potential of these cells. The investigators have made several important discoveries, such as that cardiosphere-derived cells secrete packets of RNA molecules that help cells repair the body’s tissues.

In 2011, Catherine Jayasuriya, the mother of a child with Duchenne and a patient advocate, influenced Marbán to turn his focus from studying how cardiosphere-derived cells could repair the heart after a heart attack to studying their potential for Duchenne muscular dystrophy. Jayasuriya’s fundraising provided the seed funding needed for Marbán’s laboratory to launch initial investigations. The biotechnology company Capricor Therapeutics licensed Marbán’s technology and continued the work by running clinical trials studying the safety and efficacy of deramiocel.

“This is the first Phase III trial to show that a cell therapy is effective against a genetic disease, or any type of heart disease,” said Marbán, the Mark S. Siegel Family Foundation Distinguished Professor. 

Investigators plan to continue studying the therapeutic effects of deramiocel, including whether it can be used to treat other diseases with major unmet medical needs.

“These results represent an important advance for cell-based therapy, one driven by relentless scientific pursuit made by Dr. Marbán and team,” said Shlomo Melmed, MB, ChB, executive vice president of Academic Affairs and dean of the Medical Faculty at Cedars-Sinai.

Authors: A complete list of HOPE-3 investigators can be found in the supplementary appendix of the study.

Funding: The HOPE-3 trial was funded by Capricor Therapeutics Inc.

Disclosures: Eduardo Marbán, MD, PhD, is an inventor of patents licensed by Capricor Therapeutics Inc. and holds founder's equity in the company.

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

Gilliam, 32, suffered sudden cardiac arrest, an electrical malfunction of the heart that causes it to abruptly stop beating. The odds were stacked against him: Sudden cardiac arrest kills about 90% of those who experience it outside of a hospital. Survival depended on a chain of people acting within minutes.

A fellow dancer immediately started CPR. Other dancers ran out of the dance studio in search of an automated external defibrillator (AED) and found one at a nearby dentist’s office. A speech pathologist who had just completed CPR recertification and happened to be nearby used the AED to revive Gilliam’s heartbeat.

Paramedics then rushed Gilliam to the Cedars-Sinai Emergency Department, where he had another cardiac arrest. Surgeons placed Gilliam on extracorporeal membrane oxygenation (ECMO), a form of advanced life support that temporarily took over the work of his heart, giving it time to recover—or, if necessary, bridging him to a transplant.

Cedars-Sinai experts say Gilliam’s case illustrates the importance of bystander CPR and quick medical response.

“The key to G’bari surviving sudden cardiac arrest was the fast-acting individuals who provided CPR, facilitated the use of an AED, and the Cedars-Sinai Emergency Department and cardiothoracic surgery teams who began ECMO within the hospital,” said Evan Kransdorf, MD, PhD, assistant professor of Cardiology in the Smidt Heart Institute and one member of Gilliam’s team of physicians and surgeons.

During cardiac arrest, blood stops circulating, explained Pedro Catarino, MD, a cardiothoracic surgeon in the Smidt Heart Institute at Cedars-Sinai.

“The cells of the body, particularly the brain, will die within a few minutes without circulation,” Catarino said. “Gilliam’s heart was in and out of a rhythm that doesn’t sustain circulation, so the surgery team put him on emergency life support.”

Gilliam’s heart had ceased working, so he was listed in the organ donation system. After 12 days on life support, Gilliam received the news every transplant candidate hopes for: A donor heart had become available.

“Heart transplantation offers a new chance at life for patients like Gilliam,” Catarino said. “Gilliam is an athlete and can look forward to going back to his career with a heart that has a long lifespan.”

A pathology report showed Gilliam had a severe form of hypertrophic cardiomyopathy, an inherited condition that causes the heart muscle to thicken so that the heart cannot contract and pump blood properly. The condition likely caused Gilliam’s sudden cardiac arrest, his medical experts say.

“Many people with hypertrophic cardiomyopathy don’t have symptoms, and athletes who are used to pushing themselves to be out of breath might not realize they have it,” Kransdorf said.

Geneticists in the Smidt Heart Institute tested samples of Gilliam’s heart and found that he had a genetic variant associated with hypertrophic cardiomyopathy. Experts encourage anyone with a family history to be screened for the condition, which affects about 1 in 500 people. Gilliam’s close family members are undergoing genetic testing.

Gilliam, whose credits include performing with Bad Bunny and on Jimmy Kimmel Live!, is now in physical therapy and preparing to return to dance.

“With dancing, it feels like I'm able to be my most authentic self and be the most vulnerable version of myself. It makes me feel alive,” he said.

Prior to his medical emergency, Gilliam’s schedule consisted of dance classes and gym training five days a week. He hopes to return to intense days and to continue teaching dance to elementary school students and choreographing dancers on TV and film sets. His mother and girlfriend are supporting him, as are many friends, family members and fellow dancers.

“What I learned from this experience is everyone should be trained in CPR because you never know what's going to happen,” Gilliam said. “Even more so, be a person of service. If you have the opportunity to help someone, do it.”

Read more from Cedars-Sinai Stories and Insights—Sudden Cardiac Arrest: Genetic Cause More Common in Younger People

A new study led by Karlstaedt and published in Circulation reports that a specific enzyme plays an important role in keeping the heart beating. The discovery could help scientists create drugs that mimic the enzyme’s role and help people with heart failure, a condition in which the heart becomes too weak to pump blood properly.  

Karlstaedt, assistant professor of Cardiology in the Smidt Heart Institute at Cedars-Sinai, has spent more than a decade studying heart metabolism—the chemical process that powers the heart. She spoke with the Cedars-Sinai Newsroom about her dedication to uncovering treatments for the millions diagnosed with heart failure every year.

How is the heart’s metabolism different from the metabolism of other parts of the body?

There are thousands of tiny molecules called metabolites—including amino acids, glucose and fatty acids—that act as an energy source to help cells function properly. The heart is the only organ that can use almost any metabolite.

The heart is also unique because it never stops beating. It's not like other muscles, which can rest. Fueling heart cells requires fine-tuned, organized chemical reactions. The system functions perfectly until something disrupts it, and metabolism is at its center. 

What was one of the major discoveries that led to your current work? 

My colleagues and I published a study in 2016 in which we discovered that the heart uses unusual fuel-processing routes to adapt to metabolites released by cancer cells. It’s like in a city where you have streets and traffic moves along those streets. If a construction site suddenly blocks a street, traffic finds another way around. The heart does the same thing.

We also found that in response to cancer-related metabolic stress, the heart suddenly started using an unusual enzyme called ATP-dependent citrate lyase, or ACL. This enzyme drives the process that creates fatty acids, something we didn’t think happened in heart cells. But when we blocked ACL, the heart could not pump well. That told us this enzyme might be much more important for the heart than previously thought.

Could you describe your recent discovery?

We found that when ACL slows down, heart function drops. To make this discovery, we studied heart tissue samples from people with healthy hearts and people with failing hearts. We also observed ACL in the hearts of laboratory mice. When ACL activity decreased, meaning it no longer efficiently produced fatty acids, the heart tried to adapt by taking up more sugar and rewiring parts of its metabolism. But those changes did not fully protect the heart. Instead, the heart had less available energy and did not pump as well.

To dig deeper, we used CardioNet, our computational model of heart metabolism. The model pinpointed another enzyme, IDH1, that compensates for the loss of ACL. When we reduced IDH1 in our model, the heart could pump better. We're now studying whether future heart failure therapies could target IDH1.

What do you hope to accomplish as this work progresses?

Heart failure can look similar from one patient to another, but the underlying metabolic changes may be different. We hope to use our computational model to predict which fuel pathways are disrupted in people with heart failure and which treatments can get the heart working better. We are not there yet, but this study is an important step toward understanding heart failure as a disease of both mechanics and metabolism.

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

“The majority of people who have a sudden cardiac arrest outside of a hospital will die, so the best protection is being aware of risk,” said Kyndaron Reinier, PhD, MPH, associate director of Epidemiology in the Center for Cardiac Arrest Prevention in the Smidt Heart Institute at Cedars-Sinai and an author of both studies. 

Sudden cardiac arrest happens when a problem with the heart’s electrical system causes the heart to stop beating. It is different from a heart attack, which is caused by a lack of blood flow to the heart. More than 350,000 people experience sudden cardiac arrest outside of a hospital in the U.S. each year, and only about 10% survive. 

Experts know that people with low left ventricular ejection fraction, when the heart’s main pumping chamber is weak and pumps less than it should, are at higher risk for sudden cardiac arrest. But this marker has become less effective and other indicators are needed to capture more people at risk.

“More than two-thirds of people who have cardiac arrest don’t have low left ventricular ejection fraction, so using this marker alone misses too many people,” Reinier said. 

A study published in the journal Circulation: Arrhythmia and Electrophysiology reports that warning symptoms combined with clinical history could predict imminent sudden cardiac arrest. A second study, published in the Journal of the American Heart Association (JAHA), reports that having more than one cardiac event over time could signal rising risk. 

Reading Warning Symptoms

In the Circulation: Arrhythmia and Electrophysiology study, investigators used machine learning to identify combinations of symptoms and medical history that best predicted sudden cardiac arrest in the near future. 

The study included people enrolled in two separate, longstanding studies in Oregon and Ventura County, California, that were founded by Sumeet Chugh, MD, director of the Center for Cardiac Arrest Prevention in the Smidt Heart Institute. The investigators compared 364 people who called 911 when experiencing symptoms such as chest pain and survived sudden cardiac arrest, with 313 people who called 911 for similar symptoms but did not experience sudden cardiac arrest. 

The analysis found that people with sudden cardiac arrest were more likely to have a combination of shortness of breath and diagnosed coronary artery disease or heart failure than people who did not experience sudden cardiac arrest. Seizure-like symptoms without chest pain or shortness of breath were also more common in people who experienced sudden cardiac arrest.

The investigators also found that chest pain combined with coronary artery disease predicted imminent arrest in women, while chest pain combined with heart failure predicted it in men. 

Warning symptoms most often occurred at least 15 minutes prior to the sudden cardiac arrest, a time frame that would make it possible to call 911. In earlier research, the investigators found that 81% of people delayed their 911 call, reducing their chances of successful revival by ambulance paramedics. 

These findings could be used to create risk-predicting algorithms for use by urgent care and emergency medicine providers, the investigators said. “While more research is needed, such risk prediction algorithms have the potential to avoid 911 call delays following warning symptoms of sudden cardiac arrest,” said Chugh, vice dean and chief AI health research officer at Cedars-Sinai.

Tracking Risk Over Time

The JAHA study was carried out in the Observational Study of Cardiac Arrest Risk (O.S.C.A.R.) cohort at Cedars-Sinai, established by Chugh, that has been tracking the health of approximately 400,000 residents of Los Angeles County from 2017 onward. Of these, the investigators followed more than 6,700 people hospitalized at Cedars-Sinai for heart failure and more than 2,900 people hospitalized in the health system for acute coronary syndrome, when an artery blockage reduces blood flow to the heart. 

Investigators found that patients in both groups who experienced a recurrent cardiovascular event faced a higher risk of sudden cardiac arrest. 

Patients who had a second coronary artery blockage were more than three times as likely to experience sudden cardiac arrest as those without a recurrence. Patients who were hospitalized a second time for heart failure were nearly twice as likely to experience sudden cardiac arrest. Risk climbed with each additional heart failure hospitalization. The investigators compared the findings to what was found in participants of the Framingham Heart Study, which enrolled participants about 50 years earlier. The results were similar, however the heart failure result in that study did not reach statistical significance.

Reinier said that physicians should consider sudden cardiac arrest as being more likely when a patient is hospitalized for a heart issue a second time.

“This may mean running additional tests,” Reinier said. “It may mean educating the patient about what cardiac arrest is and the importance of having a family member who knows to call 911 and start CPR immediately if their loved one collapses.”

Moving Beyond Dead Ends

Chugh, senior author of both studies, said the combined findings point toward a more flexible approach to prediction.

“Near-term and long-term predictions are parallel approaches that can help us move past roadblocks we face in preventing death from this lethal heart event,” Chugh said.

Additional research, including studies in different populations, are needed to confirm whether the factors the investigators studied could be used in prediction tools, study authors said. 

Cedars-Sinai investigators continue to study predictors of sudden cardiac arrest, and their work includes using AI to study patterns in heart tests called electrocardiograms and looking for genetic causes. 

Additional Cedars-Sinai authors in the Circulation: Arrhythmia and Electrophysiologystudy include Harpriya Chugh, BS; Vishnu Kadiyala, MD; Arayik Sargsyan, MPH; Audrey Uy-Evanado, MD; Kotoka Nakamura, PhD; Elizabeth Heckard, MS; Marco Mathias, BS.

Other authors include Tristan Grogan, MS; David Elashoff, PhD; Angelo Salvucci, MD; and Jonathan Jui, MD, MPH.

Funding: Dr. Chugh was funded by the National Heart Lung and Blood Institute, National Institutes of Health.

Additional Cedars-Sinai authors in the Journal of the American Heart Association study include Marita Knudsen Pope, MD, PhD; Harpriya Chugh, BS, MSHS; Thien Tan Tri Tai Truyen, MD; Marco Mathias, BS; and Audrey Uy-Evanado, MD.

Other authors include Honghuang Lin, PhD; Dan Atar, MD, Nichole Bosson, MD, MPH, and Emelia J. Benjamin, MD, ScM

Funding: The Framingham Heart Study is funded by the National Heart, Lung, and Blood Institute, National Institutes of Health. Dr. Benjamin is partially funded by The National Heart, Lung, and Blood Institute, National Institutes of Health.

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

La Dra. Janet Wei cardióloga del Smidt Heart Institute, es una de las autoras de un informe sobre salud materna de la National Academies of Sciences, Engineering, and Medicine, una organización sin fines de lucro que revisa la investigación publicada y asesora al gobierno de EE. UU. Wei, profesora asociada de Cardiología y Ciencias Biomédicas, conversó con el Newsroom de Cedars-Sinai para explicar cómo el embarazo afecta el corazón de las mujeres.   

¿Cómo aumenta el embarazo el riesgo cardiovascular?

El embarazo actúa como una prueba de esfuerzo para el corazón y puede revelar, o incluso empeorar, problemas como la presión arterial alta y la diabetes. Durante el embarazo, el corazón debe trabajar más para mantener al feto en crecimiento, y el estrés cardíaco suele continuar después del parto.

Las enfermedades cardiovasculares son la principal causa de muerte relacionada con el embarazo en EE. UU., aunque la mayoría de estas muertes son prevenibles. El informe sobre salud materna de la National Academies of Sciences, Engineering, and Medicine destaca que, si bien el 57% de las muertes relacionadas con causas cardiovasculares ocurren entre los siete días y un año posteriores al parto, la atención preventiva suele centrarse en el período prenatal y en el posparto inmediato.

¿Cuáles son dos conclusiones clave del informe?

El comité revisó investigaciones médicas publicadas y recabó aportes de una amplia variedad de actores, incluidos médicos, sociedades profesionales, organizaciones de defensa de los pacientes y pacientes.

Surgieron varias conclusiones claras. El informe recomienda, por ejemplo, que los médicos traten a las mujeres embarazadas con hipertensión crónica para reducir su presión arterial a menos de 140/90 milímetros de mercurio.  Esto se debe a que una presión arterial constantemente elevada durante el embarazo puede provocar complicaciones y aumentar el riesgo de una mujer de desarrollar enfermedades cardiovasculares.

Las nuevas directrices también recomiendan que los médicos que atienden a pacientes con hipertensión posparto u otros trastornos hipertensivos les proporcionen monitores de presión arterial para el hogar y utilicen un programa que permita a las pacientes reportar sus lecturas. De esta manera, los médicos pueden ajustar el tratamiento y establecer umbrales claros de acción. 

Cedars-Sinai ya está haciendo esto a través de un programa de monitoreo de la presión arterial posparto que envía a las pacientes a casa con un brazalete de presión arterial y les permite transmitir sus lecturas a sus equipos de atención. (Dra. Kimberly Gregory, MPH, directora de la División de Medicina Materno-Fetal de Cedars-Sinai, se desempeñó como asesora del comité de la National Academies que elaboró el informe sobre salud materna.)

¿Con qué frecuencia deben las mujeres visitar al médico durante el año posterior al parto?

La frecuencia con la que una mujer debe consultar a su médico durante el período posparto depende de su riesgo cardiovascular. 

No todas las mujeres pueden consultar fácilmente a un médico o especialista de la salud, especialmente en zonas rurales o cuando el costo es un factor. Por ello, el informe de la National Academies recomienda que la Health Resources and Services Administration utilice sus programas de telesalud, salud rural y salud materna, para reducir las barreras geográficas, financieras y del sistema que dificultan el acceso a servicios cardiovasculares preventivos.

¿Qué pueden hacer las mujeres embarazadas para proteger la salud de su corazón?

La National Academies creó un recurso para mujeres que incluye los siguientes consejos:

Comparte tu historial. Cuéntale a tu equipo de atención médica tu historial familiar de enfermedades cardíacas, especialmente infartos o derrames cerebrales tempranos, y tu historial de embarazos, incluidas complicaciones anteriores.

Mantén las citas de seguimiento posparto en tu calendario. Es importante no faltar a estas citas, ya que el riesgo de complicaciones continúa durante todo el primer año después del parto.

Toma en serio las señales de advertencia: confía en tus instintos. Si algo se siente mal durante el embarazo o después del parto, busca atención de inmediato e informa a los profesionales de la salud que estás embarazada o que diste a luz recientemente.

Lea más en Cedars-Sinai Stories and Insights: Presión Arterial Alta—Lo Que las Mujeres Deben Saber

Shehata is a cardiac electrophysiologist, a doctor who specializes in diagnosing and treating problems with the heart’s electrical system. He has experience with a broad spectrum of heart rhythm disorders and also cares for people with heart failure and survivors of cardiac arrest.

“Over the past two decades, Dr. Shehata has emerged as a nationally recognized cardiac electrophysiologist and academic leader,” said Susan Cheng, MD, MMSc, MPH, chair of the Department of Cardiology in the Smidt Heart Institute. “His leadership will mean continued progress in this important field.”

As a researcher, Shehata has led groundbreaking clinical trials for new types of pacemakers and other technologies for treating heart rhythm disorders. He also studies ways that AI can be used to personalize care.

Shehata’s most recent research includes a trial of a new treatment for atrial fibrillation, which occurs when the upper chambers of the heart beat out of sync with the lower chambers of the heart. The treatment, pulsed field ablation, targets heart cells involved in an abnormal heart rhythm. The U.S. Food and Drug Administration approved several pulsed field ablation systems, including one studied by Shehata and other researchers, in 2024.

Shehata and colleagues have also studied leadless pacemakers, miniature devices that attach to the heart muscle and that, unlike traditional pacemakers, don’t require a battery and wires.

As division director, Shehata will oversee a program that provides research-backed care and trains new heart rhythm specialists. The program offers a two-year fellowship to medical school graduates seeking advanced knowledge and skills in electrophysiology.

“Through his leadership of the Interventional Electrophysiology Laboratory and the Clinical Cardiac Electrophysiology Fellowship Program, Dr. Shehata has expanded access to advanced therapies and enhanced the training of future electrophysiologists,” said Eduardo Marbán, MD, PhD, executive director of the Smidt Heart Institute and the Mark S. Siegel Family Foundation Distinguished Professor.

Shehata earned his medical degree from the University of California, San Diego, School of Medicine. He completed internal medicine residency training at UCLA and his cardiology fellowship training at Cedars-Sinai, where he was chief fellow. He also completed advanced fellowship training in cardiac electrophysiology at Cedars-Sinai. He served as faculty at UCLA before being recruited to join the cardiology faculty at Cedars-Sinai, where he is a professor of Cardiology.

U.S. News & World Report rates the Smidt Heart Institute a top 10 cardiovascular center in the U.S. and #1 in California.

Read more from Cedars-Sinai Stories and Insights: New AFib Treatment Helps Dad Regain His Heart Rhythm

The 52-year-old has always enjoyed a high-energy lifestyle, managing the intensity of producing films and television shows (Ladder 49, Flight Plan, Top Gear, Wheeler Dealers) by eating healthy, running and biking along the Los Angeles River. After his daughter was born in 2020, Nieminen assumed his constant exhaustion was the typical kind that comes with sleepless nights caring for a newborn. Still, he and his wife, Kaisa, found it odd that picking up his daughter left him depleted.

“My battery was constantly drained,” Nieminen said. “Being physically active all my life, it was quite alarming. Deteriorating this quickly when I’m just over 50 seemed sort of dramatic.”

Nieminen also noticed his heart seemed to beat too fast at times and occasionally it would skip a beat, so in 2023 he made an appointment with Cedars-Sinai cardiologist Ronit Zadikany, MD. Zadikany diagnosed him with atrial fibrillation, an irregular heart rhythm that occurs when the upper and lower chambers of the heart beat out of sync. The condition tends to worsen with time and can cause the heart to beat too slowly, too quickly or irregularly, impeding blood flow. Common symptoms include fatigue, heart palpitations, dizziness and reduced stamina. Left untreated, atrial fibrillation can cause a slew of cardiovascular complications—including stroke.

Nieminen’s cardiologist referred him to Christine M. Albert, MD, MPH, an expert in atrial fibrillation and chair of the Department of Cardiology in the Smidt Heart Institute. Albert recommended cardioversion, a procedure commonly used to reset the heart to a normal rhythm. The results made Nieminen feel like himself again, but only for a day. A second cardioversion combined with a medication known to work for many people also had temporary effects.

Albert was determined to find Nieminen a treatment that would have long-term results. She suggested he might benefit from catheter ablation, a procedure that destroys cells and creates a small scar within the heart, breaking up or insulating the electrical signals causing the heart to beat out of sync. She connected him with Michael Shehata, MD, a cardiac electrophysiologist in the Smidt Heart Institute.

Shehata was leading a clinical trial investigating a new catheter ablation called pulsed field ablation. Rather than create scars, pulsed field ablation targets heart cells involved in an abnormal heart rhythm.

Nieminen underwent the procedure in January 2024.

“When other options fail, this procedure can be life-changing for patients,” Shehata said.

Pulsed field ablation is done by threading a catheter through a vein in a patient’s leg until it reaches the top chambers of the heart. Once in place, a cardiologist sends a high-voltage electrical impulse through the catheter. The energy penetrates cell walls and destroys specific heart cells, preventing abnormal signals from causing an irregular heartbeat. The procedure takes 30 to 60 minutes.

“The energy is delivered specifically to heart cells without injuring nerve cells, smooth muscle cells, or other, healthy cells,” said Shehata, who is also director of the Interventional Electrophysiology Laboratory at the Smidt Heart Institute. “For some patients with atrial fibrillation, this procedure may be safer than conventional ablation procedures that destroy small areas of heart tissue.”

Following U.S. Food and Drug Administration approval of several pulsed field ablation systems, the procedure is now available for use outside of a clinical trial.

Advances in treatment couldn’t come at a better time. Atrial fibrillation is the most common type of irregular heartbeat and deaths related to the condition have been increasing for more than two decades, according to the U.S. Centers for Disease Control and Prevention.

Today, Nieminen is back to long runs and cycling through his neighborhood. He also works with local organizations to advocate for safe walking and biking paths in Los Angeles. Most importantly, he can now lift his daughter into the air like the high-energy dad he is.

A device that was implanted to record Nieminen’s heart rhythm shows proof of his progress: He has been free from atrial fibrillation since getting pulsed field ablation.

“Don’t hesitate to share with your doctors when something feels off because you feel like you’re being a hypochondriac or you think it’s too insignificant to bring up,” he said. “As you get older, it’s especially important to listen to your body, eat right and stay active, and that doesn’t necessarily mean doing a 10K. Everything your mom would tell you growing up: Stay active, eat healthy, get sleep and get checkups with your doctor. Mom knew what she was talking about.”

Read more on Cedars-Sinai Stories and Insights: Back Into Rhythm | Adjusting to an AFib Diagnosis

Smidt Heart Institute cardiologist Janet Wei, MD, is one of the authors of a maternal health report from the National Academies of Sciences, Engineering, and Medicine, a nonprofit organization that reviews published research and provides advice to the U.S. government. Wei, associate professor of Cardiology and Biomedical Sciences, sat down with the Cedars-Sinai Newsroom to explain how pregnancy affects women’s hearts.   

How does pregnancy increase cardiovascular risk?

Pregnancy acts as a stress test for the heart and can uncover, or even worsen, problems like high blood pressure and diabetes. During pregnancy, the heart must work harder to support a growing fetus, and cardiac stress often continues after delivery.

Cardiovascular disease is the leading cause of pregnancy-related death in the U.S., yet most of these deaths are preventable. The National Academies of Sciences, Engineering, and Medicine report on maternal health highlights that although 57% of cardiovascular-related deaths occur between seven days and one year postpartum, preventive care is often focused on the prenatal and immediate postpartum period.

What are two takeaways from the report?

The committee reviewed published medical research and gathered input from a wide range of stakeholders, including clinicians, professional societies, advocacy organizations and patients.

Several takeaways became clear. The report recommends, for example, that clinicians treat pregnant women with chronic hypertension so that their blood pressure is reduced to less than 140/90 millimeters of mercury.  This is because consistently elevated blood pressure during pregnancy can cause pregnancy complications and increase a woman’s risk for developing cardiovascular disease.

The new guidelines also recommended that clinicians caring for patients with postpartum hypertension or other hypertensive disorders give their patients home blood pressure monitors and use a program that allows the patients to report their readings. This way, clinicians can adjust treatment and set clear thresholds for action. 

Cedars-Sinai is already doing this through a postpartum blood pressure monitoring program that sends patients home with a blood pressure cuff and allows them to transmit readings to their care teams. (Kimberly Gregory, MD, MPH, director of the Division of Maternal-Fetal Medicine at Cedars-Sinai, served as an adviser to the National Academies committee that created the maternal health report.)

How often should women visit a doctor in the year after giving birth?

How frequently a woman should see her doctor during the postpartum period depends on her cardiovascular risk. 

Not every woman can easily see a doctor or health specialist—especially in rural areas or when cost is a concern. Therefore, the National Academies report recommends the Health Resources and Services Administration use its telehealth, rural health and maternal health programs to reduce geographic, financial and system barriers to preventive cardiovascular services.

What can pregnant women do to protect heart health?

The National Academies created a resource for women that includes the following advice:

Share your history. Tell your healthcare team your family history of heart disease, especially early heart attacks or strokes, and your pregnancy history, including any past complications.

Keep postpartum follow-up appointments on your calendar. It’s important not to miss these appointments because risk for complications continues through the first year after delivery.

Take warning signs seriously—trust your instincts. If something feels wrong during pregnancy or after birth, seek care right away and tell providers that you’re pregnant or that you gave birth recently.

Read more from Cedars-Sinai Stories and Insights: High Blood Pressure—What Women Need to Know

Younger people who experience sudden cardiac arrest are more likely to have a genetic cause than older people who experience it, according to new research from the

“If you have a family member who suffered sudden cardiac arrest, it is important to undergo genetic testing to determine if you harbor a genetic variant that increases your risk of sudden cardiac arrest or other heart conditions,” said Evan Kransdorf, MD, PhD, assistant professor of Cardiology in the Smidt Heart Institute and first author of the study. “For people who carry a variant linked to sudden cardiac arrest, a cardiologist can prescribe medications or lifestyle changes that can decrease the chances of experiencing this dangerous event.”

Sudden cardiac arrest, an electrical malfunction that causes the heart to beat very rapidly, is fatal in 90% of cases, according to the American Heart Association. The Cedars-Sinai Health Sciences University investigators found that 10% of people 29 and younger who have sudden cardiac arrest carry genetic variants linked with the condition.

The team analyzed blood samples from more than 3,000 people who experienced sudden cardiac arrest in Portland, Oregon, and Ventura County, California. The samples came from the ongoing Oregon Sudden Unexpected Death Study and the Ventura Prediction of Sudden Death in Multi-Ethnic Communities study—both created by Sumeet Chugh, MD, director of the Center for Cardiac Arrest Prevention in the Smidt Heart Institute, to improve understanding of the condition.

Investigators performed whole genome sequencing, which maps a person’s entire genetic code. They identified 15 genes in which damaging genetic variants can occur and disrupt the gene’s function and increase risk of sudden cardiac arrest. They found the prevalence of damaging genetic variants decreased with age:

• 10% of people age 29 and younger harbored a damaging genetic variant.
• 7% of people age 30-49 harbored a damaging genetic variant.
• 4% of people age 50-69 harbored a damaging genetic variant.
• 3% of people age 70 and older harbored a damaging genetic variant.

In older people, sudden cardiac arrest is more likely to be caused by a narrowed or blocked heart blood vessel rather than a heart condition caused by a damaging genetic variant, according to the investigators.

The investigators said more research will help uncover other genes linked to sudden cardiac arrest.

“This study is more representative of the U.S. population than other studies because it includes data from two communities rather than data from people already being seen at a medical center,” said Chugh, who is also vice dean and chief artificial intelligence health research officer at Cedars-Sinai and senior author of the study.

Additional Cedars-Sinai authors include Marco Mathias, BS; Kotoka Nakamura, PhD; Harpriya Chugh, BE, MSHS; David Nguyen, BS; Paul D. Pharoah, MD, PhD; and Kyndaron Reinier, MPH, PhD.

Other authors include Jonathan Tyrer, PhD; Zeynep Akdemir, PhD; Eric Boerwinkle, PhD; and Bing Yu, PhD. 

Funding: The study was funded by The National Institute of Health, NHLBI Grants R01HL145675 and R01HL147358; NIH DHHS Contracts HHSN268201700001I, HHSN268201700002I, HHSN268201700003I, HHSN268201700004I, HHSN268201700005I.

Read more from Cedars-Sinai Stories and Insights: Heart Attack, Cardiac Arrest, Heart Failure—What’s the Difference?

The study, “Real-World Outcomes of Transcatheter Tricuspid Valve Replacement: Analysis From the STS/ACC TVT Registry,” published in the Journal of the American Medical Association.

“These findings show that transcatheter tricuspid valve replacement is translating well from the clinical trial setting into routine practice across the United States,” said Raj Makkar, MD, vice president of Cardiovascular Innovation and Intervention at Cedars-Sinai, the Karsh Distinguished Chair in Interventional Cardiology in the Smidt Heart Institute, and corresponding author of the study. “In a large, older and medically complex patient population, we saw very high procedural success, near-complete elimination of tricuspid regurgitation, and rapid improvement in how patients feel and function.”

Tricuspid regurgitation occurs when the tricuspid valve does not close properly, allowing blood to flow backward in the heart. The condition is common in older adults and can lead to worsening heart failure symptoms, repeated hospitalization and increased risk of death.

Historically, open-heart surgery was often the only treatment option for this condition, but many older patients were not candidates because of age or other medical problems. Today, transcatheter tricuspid valve replacement offers a less invasive alternative in which doctors replace the damaged valve using a catheter, or tube, threaded through a blood vessel.

Researchers analyzed 1,034 attempted TTVR procedures performed between February 2024 and March 2025 at 82 medical centers across the U.S. The average patient age was 77.

The analysis found that more than 98% of patients had the valves successfully implanted. At 30 days post-procedure, more than 97% of patients had their condition improve to mild or minimal tricuspid regurgitation, and patients reported substantial improvement in symptoms, physical and social function, and quality of life.

Study authors note that early real-world outcomes were consistent with results from the TRISCEND II randomized trial of TTVR. Patients in this new study, however, experienced lower incidence of bleeding and heart block requiring electronic pacemaker implantation than patients participating in TRISCEND II. The current study also found that outcomes were generally consistent in patients with and without preexisting cardiac implantable electronic devices such as pacemakers, an important finding because these devices are common in patients with severe tricuspid valve disease.

“For patients with severe tricuspid regurgitation, treatment options have historically been limited, especially when surgery carries high risk,” said Aakriti Gupta, MD, assistant professor of Cardiology and study author. “What is especially encouraging here is that in real-world care, not just in a randomized trial, patients experienced meaningful improvement in symptoms and quality of life within only 30 days.”

Investigators said the results support the growing role of TTVR as a treatment option for patients with severe tricuspid regurgitation and highlight the importance of continued follow-up to understand longer-term outcomes.

Moody Makar, MD, associate professor of Anesthesiology at Cedars-Sinai, is also an author of the study.

Additional authors include Brian P. O’Neill, MD; Christina Lalani, MD; Rahul Sharma, MBBS; Pradeep Yadev, MD; Tiberio M. Frisoli, MD; Vinod Thourani, MD; Mackram F. Eleid, MD; James Lee, MD; Vasilis C. Babaliaros, MD; Christiane Haeffele, MD, MPH; Tanvir J. Bajwa, MD; Peter Flueckiger, MD; Robert J. Cubeddu, MD; Laura J. Davidson, MD; Ratnasari Padang, MBBS, PhD; Pedro Villablanca Spinetto, MD; Suhail Allaqaband, MD; Akhil Narang, MD; Mathew Williams, MD; Patrick Gleason, MD; Gilbert H.L. Tang, MD; Sahil Khera, MD; John P. Vavalle, MD; Isida Byku, MD; Jeremiah P. Depta, MD; Santiago Garcia, MD; Samir Kapadia, MD; Alan Zajarias, MD; Jake M. Chanin, MD; Susheel K. Kodali, MD; Howard C. Herrmann, MD; M. Andrew Morse, MD; George Petrossian, MD; Joseph A. Sivak, MD; Rebecca T. Hahn, MD; Yang Song, PhD; Martin B. Leon, MD; Robert W. Yeh, MD, MSc; Charles J. Davidson, MD.

The study was funded by Edwards Lifesciences.

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

A New Algorithm Could Improve Location of Lifesaving Devices

Cedars-Sinai Health Sciences University investigators and colleagues created an algorithm designed to use data on sudden cardiac arrests to determine the best public locations for lifesaving devices called automated external defibrillators. Their findings were published in IJC Heart & Vasculature.

Known as AEDs, the portable devices deliver an electrical shock, with an aim to restart the heart when it stops beating due to sudden cardiac arrest. Sudden cardiac arrest is common and usually fatal when it happens somewhere other than a hospital.

“Research shows that the sooner a bystander can locate and use an AED, the higher the likelihood that the person experiencing sudden cardiac arrest survives,” said Sumeet Chugh, MD, vice dean and chief AI Health Research Officer at Cedars-Sinai, and senior author of the paper.

The investigators reviewed data on incidents of sudden cardiac arrest in Ventura County, California, and Multnomah County, Oregon, that took place between 2012 and 2023. The algorithm they created identified clusters of three or more incidents that occurred within a 100-meter radius of each other, and proposed AED locations within 200 meters of where these clusters occurred. 

Future studies will be needed to determine whether the algorithm is an improvement over current AED location strategies, the investigators said.

“These community-based studies are a huge team effort that involves ongoing collaborations with colleagues in emergency medical services and the fire department,” said Chugh, who is also director of the Center for Cardiac Arrest Prevention in the Smidt Heart Institute. “We hope researchers use this algorithm to study how the placement of AEDs reduces deaths from sudden cardiac arrest.”

Cedars-Sinai investigator Elizabeth Heckard, MS, is first author of the paper. Additional Cedars-Sinai authors include Harpriya Chugh, BE, MSHS, and Kyndaron Reinier, PhD, MPH.

Other authors include Katy Hadduck, Bryan McNally, Ali Sovari, Jonathan Jui, and Angelo Salvucci.

Cedars-Sinai Studies Pharmacist-Led Transitions-of-Care in Older Adults

Older hospitalized patients who struggled with taking their medications correctly were 10% less likely to need to return to the hospital if they had a pharmacist’s help at discharge, according to a new multisite clinical trial based at Cedars-Sinai. But the findings, published in JAMA Network Open, found the extra help didn’t significantly reduce unplanned hospital visits for the rest of those 55 and older.

The trial included more than 6,000 hospitalized older adults on high-risk or multiple medications, randomly assigning some to receive special pharmacist-led review of their medications and follow-up based on any issues identified. Investigators tracked patients’ hospital readmissions and emergency department visits for 30 days after discharge.

“The study suggests that pharmacist-led care could be beneficial for certain patients,” said Joshua Pevnick, MD, MSHS, co-director of the Cedars-Sinai Division of Clinical Informatics, associate professor of Medicine and corresponding author of the study. “With this new data, we encourage hospital care teams to ensure they support patients with low medication adherence and understanding, as they likely would benefit most from the efforts of our strong pharmacy transitions-of-care team.”

Other Cedars-Sinai authors include An T. Nguyen, OTD, OTR/L, BCG; Kallie Amer, PharmD, BCPS; Carl T. Berdahl, MD, MS; Galen Cook Wiens, MS; Hiroshi Gotanda, MD, PhD; James Guan, PharmD, BCPS; Andrew J. Henreid, MS, MPH; Donna W. Leang, PharmD, MSHS, BCPS; Yervant Malkhasian, PharmD; Teryl K. Nuckols, MD, MSHS; Audrienne S. Ortiz, PharmD, BCPS; Emily Phung, PharmD, BCPS; Nabeel Qureshi, PhD, MPH; Rita Shane, PharmD; and Shirley Wu, PharmD, BCPS.

Other authors include Korey Kennelty, PharmD, MS, PhD, BCGP, John Fanikos, RPh, MBA; Julie Fiskio; Michelle S. Keller, PhD, MPH; Eunji M. Ko, PharmD; Lina Matta, PharmD, MPH, BCPS; Dylan Moriarty, PharmD, BCACP, BCGP; Logan Murry, PharmD, PhD; Annie Muske, PharmD; Onyeche Oche, RPh, PhD, MBA-HCA; and Jeffrey L. Schnipper, MD, MPH, MHM on behalf of the PHARM-DC Group.

Funding support for this study was provided by the National Institutes of Health, National Institute on Aging, grant number R01AG058911 (to Joshua Pevnick). Additional funding support was provided by the UCLA Clinical and Translational Science Institute under grant number UL1TR001881 and the American Society of Health-System Pharmacists Research and Education Foundation.

Scientists Target Key Protein Duo Driving Colon, Liver Cancer

Cedars-Sinai Health Sciences University investigators have identified a drug-like compound that prevents two proteins from working together to promote the growth of colorectal and liver cancer. Findings from the preclinical study were published in Cell Death & Disease.

Investigators focused on the proteins GIT1 and MAT2B, which are found at unusually high levels in these cancers. The proteins partner to form a “scaffolding” that drives cancer growth. The team discovered that a compound called C3 targets GIT1 and disrupts this structure. The disruption slows cancer cell growth and triggers cancer cell death, which helps prevent the cancer from spreading.

Colorectal cancer is among the most diagnosed cancers, and its spread to the liver is a common, serious and life-threatening complication.

“We were pleased to find a promising drug candidate that attacks colon and liver cancers simultaneously,” said Shelly Lu, MD, the Women’s Guild Chair in Gastroenterology, director of the Karsh Division of Gastroenterology and Hepatology at Cedars-Sinai, and the study’s corresponding author. “And because GIT1 is overactive in many cancers, this discovery could have broad and powerful applications in cancer treatment.”

The next step is to refine the compound to improve its effectiveness.

In related research, Lu, a member of Cedars-Sinai Cancer, and Cedars-Sinai investigators recently uncovered another way colorectal cancer spreads. They found that cancer cells release two forms of an enzyme called MATα2 that work together to weaken the liver’s natural defenses, which helps cancer spread to the liver and survive there. The findings suggest that blocking this process could offer another promising future treatment approach.

Additional Cedars-Sinai authors include Hui Peng, Jyoti Chhimwal, Wei Fan, Jiaohong Wang, Lucia Barbier-Torres, Sonal Sinha, Avradip Chatterjee, Yi Zhang, Maria Lauda Tomasi and Ramachandran Murali.

Additional authors include Jose M. Mato.

Funding: The work was supported by NIH grant P01CA233452 (SC Lu, ML Tomasi), Plan Nacional of I+D SAF2017-88041-R (JM Mato).

Disclosures: SCL and RM have filed a patent for small molecule inhibitors of GIT1 (Title: COMPOUNDS AND METHODS FOR TREATING CANCERS; Application No. 63/422,672; Filed: Nov. 4, 2022).  

Cedars-Sinai Creates First Working Model of Specialized Gut Cells

Cedars-Sinai Health Sciences University investigators have for the first time created human intestinal organoids that include functional Paneth cells, a specialized cell type that is found in the inner lining of the intestine. This achievement, published in Cellular and Molecular Gastroenterology and Hepatology, facilitates study of the cells’ role in health and disease and opens new opportunities for understanding gastrointestinal disorders.

Organoids are tiny groups of cells, grown in the lab, that mimic some of the structure and functions of actual organs. The organoids are generated from induced pluripotent stem cells, which can be turned into many different cell types.

“The model of Paneth cells that we developed can facilitate research into how genetic variations, microbes and the intestines’ immune system influence them,” said Robert Barrett, PhD, associate professor of Medicine and Biomedical Sciences and corresponding author of the study. “This knowledge is important because changes in Paneth cells are associated with chronic gastrointestinal disorders such as Crohn’s disease that involve abnormal reactions of the immune system.”

No team of investigators had previously been able to grow intestinal organoids that included functional Paneth cells. By changing the environment in which the organoids were grown, investigators this time were successful. In addition, because organoids derived from induced pluripotent stem cells carry the donor’s genetic material, the new model eventually could lead to personalized treatments for gut illnesses such as inflammatory bowel disease, according to the investigators.

Additional Cedars-Sinai authors include Shachi Patel, Monica Silveira Wagner, Olivia Bay, Christian E. Wong Valencia, Eliska Zgarbova, Cynthia I. Rodriguez, Daniel N. Leal, Michifumi Yamashita, Suzanne Devkota, Kathrin S. Michelsen and Stephan R. Targan.

Funding: Supported by the National Institutes of Health R01 DK123511 (SRT) and the F. Widjaja Inflammatory Bowel Disease Institute. MSW and CWV were supported by the California Institute for Regenerative Medicine (CIRM EDUC4-12751). The study sponsors played no role in the study design collection, analysis, or interpretation of data.

Disclosures: Shachi Patel, Monica Silveira Wagner, Stephan R. Targan and Robert J. Barrett are named as inventors on a U.S. Application No. 19/458,165, each titled “Methodologies to Generate Human Paneth Cells and Enterochromaffin Cells and Determine Their Responses.” The remaining authors disclose no conflicts.

Study Identifies Genetic Drivers of Resistant Hypertension

Cedars-Sinai investigators have identified distinct genetic variants associated with resistant hypertension, a type of high blood pressure that remains uncontrolled despite medication. Their findings, published in the journal Hypertension, suggest potential targets for diagnosing and treating this serious condition.

More than 10% of people with high blood pressure have resistant hypertension, which means they face higher risk of cardiovascular illness and death than people with nonresistant high blood pressure do.

Investigators reviewed genetic data on 92,740 people with consistently high blood pressure in Finland and the United Kingdom. The study identified variants in genes involved in hormonal regulation and blood vessel function that are highly associated with resistant hypertension. The findings highlight overproduction of the hormone aldosterone as a likely cause of difficult-to-control blood pressure.

“Understanding the genetic and bodily pathways that predispose individuals to resistant hypertension may help us identify these patients,” said co-corresponding author Joseph Ebinger, MD, associate professor of Cardiology and director of the Coronary Intensive Care Unit and Clinical Analytics in the Smidt Heart Institute at Cedars-Sinai. “This knowledge can help us develop strategies to lower their blood pressure and reduce their risk for heart attacks and other potentially fatal cardiovascular events.”

Additional Cedars-Sinai authors include Sandy Y. Joung, MSHS, MBA, and Susan Cheng, MD, MPH.

Other authors include Anni Kauko, PhD; Felix Vaura, MD; Paul Hage, BS; Johan Sundström, MD; FinnGen; and Teemu Niiranen, MD.

Funding: This work was funded by the Academy of Finland (321351), the Finnish Foundation for Cardiovascular Research, the Paavo Nurmi Foundation, the Sigrid Juselius Foundation, the Mary and Georg Ehrnrooth Foundation, the Hospital District of Southwest Finland, and the National Institutes of Health grants R01-HL134168, R01-HL131532, R01-HL143227, R01-HL142983, K23-HL153888, K23-HL136853, and R01-HL153382.

New Method Rapidly Analyzes Cell Proteins and Metabolites

Researchers at Cedars-Sinai have developed a fast, new technique for analyzing cells, described in the journal Angewandte Chemie. The approach, called single-injection multi-omics analysis by direct infusion (SMAD), can detect more than 1,300 proteins and more than 9,000 molecular features from a single sample in less than five minutes. The method could help researchers study health, disease and drug responses more quickly and at lower cost, while simplifying analyses that usually require more complex workflows.

To show how the method can be used, the researchers applied it in several case studies. These included tracking how immune cells shift into different inflammatory states and screening how human cells respond to drug treatments.

“By making molecular analysis faster, this approach could one day accelerate drug discovery, enable more powerful machine learning models, and help move rapid, large-scale biological testing closer to clinical use,” said Jesse Meyer, PhD, senior author of the study and an assistant professor of Computational Biomedicine at Cedars-Sinai.

Additional Cedars-Sinai authors include Yuming Jiang, Amanda Momenzadeh and Jesús Muñoz-Estrada.

Other authors include Ivan Salladay-Perez, Utkarsh Tripathi and Anthony J. Covarrubias.

Funding: NIH (R35GM142502, R35GM156893, and R21AG074234).

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

Late-Breaking Science

Cardiologist Shephal Doshi, MD, is first author of clinical trial results being presented at ACC, “Outcomes In Patients With Atrial Fibrillation Randomized To Receive Left Atrial Appendage Closure Or Oral Anticoagulation: Primary Results Of The CHAMPION-AF Clinical Trial.”

Women and Cardiovascular Disease

C. Noel Bairey Merz, MD, director of the Barbra Streisand Women’s Heart Center, will co-chair “Beyond the Usual Suspects: Cracking the Female Code.” The session will explore diagnoses such as peripartum heart failure, spontaneous coronary artery dissection, postural orthostatic tachycardia syndrome, ischemia with non-obstructive coronary arteries (INOCA), and myocardial infarction with non-obstructive coronary arteries (MINOCA)—all of which predominantly affect women.

Janet Wei, MD, the Erika J. Glazer Chair in Women's Cardiovascular Research, Education and Innovation, will contribute her expertise to the sessions “ANOCA, INOCA and MINOCA Boot Camp” and “Beyond Coronary Stenosis: Unraveling INOCA With Multimodality Imaging.” She will also present a case titled “INOCA With Microvascular Dysfunction Assessed by Cardiac PET.”

AI and Cardiac Imaging

Damini Dey, PhD, professor of Biomedical Sciences, will co-chair the session “From Code to Clinic: AI Transforming Cardiac Imaging.” She and Piotr Slomka, PhD, professor of Cardiology and Medicine, are also panelists on the session.

Hypertrophic Cardiomyopathy

Florian Rader, MD, director of the Hypertrophic Cardiomyopathy Center, will co-chair the session “New Horizons in Hypertrophic Cardiomyopathy.”

ACC Awards

The Journal of the American College of Cardiology has selected Joseph Ebinger, MD, MS, associate professor of Cardiology, to receive the Simon Dack Award for Outstanding Scholarship. The award recognizes Ebinger’s exceptional contributions to the peer review process and his commitment to advancing rigorous, high-impact cardiovascular science.

JACC: Advances has selected Assistant Professor Ofir Koren, MD, as a top reviewer. This recognition honors Koren’s contributions as a JACC peer reviewer in 2025, including his thoughtful critiques, scientific discernment and dedication to scholarly excellence.

Project scientist Yuki Sahashi, MD, PhD, is the honorable mention awardee for the William W. Parmley Young Author Achievement Award. The Journal of the American College of Cardiology is recognizing Sahashi for a study he led, “Artificial Intelligence Automation of Echocardiographic Measurements.”

Experts Available to Comment

Smidt Heart Institute experts are available to comment on research related to AI and imaging, cardiac surgery, noninvasive procedures, potential new therapies, and other topics presented at ACC.26. To schedule an interview, contact Stephanie Cajigal at stephanie.cajigal@cshs.org, or via mobile and What’s App: (United States) +1-347-806-2938.

Throughout her career, Cheng has maintained National Institutes of Health funding for research aimed at uncovering the drivers of cardiovascular aging. She has authored more than 450 scientific studies, many appearing in high-impact journals, including JAMA, Circulation and The New England Journal of Medicine.

Cheng identified differences in how males and females develop elevated blood pressure and demonstrated how people vary in their responses to COVID-19 vaccines over time. Her research has garnered multiple awards and contributed to Cedars-Sinai’s reputation as an international leader in biomedical sciences.

“Dr. Cheng is the perfect leader to build and enrich our already flourishing Department of Cardiology,” said Shlomo Melmed, MB, ChB, dean of the Medical Faculty and executive vice president of Medicine and Health Sciences. “We welcome her to this academic leadership role and look forward to the contributions she will make in strengthening the Smidt Heart Institute.”

Cheng, who succeeds Christine M. Albert, MD, MPH, has served on the editorial boards of major professional journals and on leadership committees for the American Society for Clinical Investigation, the American Heart Association and the American College of Cardiology.

She founded the largest COVID-19 clinical research program on the West Coast at the outset of the pandemic in 2020. More recently, she has led research to investigate the public health effects of the 2025 Los Angeles wildfires.

Cheng has mentored dozens of junior faculty members in cardiology, anesthesiology, neurology, obstetrics and oncology, taking special pride in advising early-career investigators as well as high school and college students.

“I look forward to supporting the Smidt Heart Institute’s talented clinicians and researchers as they work to improve the lives of those affected by cardiovascular disease,” Cheng said.  

Cheng received her bachelor’s degree from Harvard College and her medical degree from McMaster University in Canada, as well as a master of medical science degree from the Massachusetts Institute of Technology and a master of public health degree from Harvard University. She completed her internal medicine training at Johns Hopkins University and cardiology training at Brigham and Women’s Hospital, where she served as associate director of the Cardiovascular Imaging Core Laboratory.

In her new role, Cheng will lead strategic clinical, research and educational growth for the Department of Cardiology. As the new department chair, she will hold the Stephen R. Corday, MD, Distinguished Chair in Cardiology.

“Dr. Cheng has strengthened our institution and made many meaningful contributions through her research laboratory since joining Cedars-Sinai seven years ago,” said Eduardo Marbán, MD, PhD, executive director of the Smidt Heart Institute and the Mark Siegel Family Foundation Distinguished Chair. “We are excited for her to continue developing our world-class cardiology department.”

Read more from the Cedars-Sinai Newsroom: Cedars-Sinai Reports Heart Attacks, General Illness Spiked After LA Fires

“Too often, when a young woman has heart disease symptoms, a physician will ignore those symptoms and tell her that she needs to lose weight,” said Bairey Merz, director of the Barbra Streisand Women’s Heart Center in the Smidt Heart Institute at Cedars-Sinai. “That’s because heart disease symptoms in women can be very different from what men experience. So it’s crucial that women know what to look for.”

Although heart disease is the leading cause of death among women in the U.S., according to the Centers for Disease Control and Prevention, most heart disease research has been conducted on men. And even though rates of heart disease and heart attacks are increasing among women 35 to 54 years old, they are less likely to receive evidence-based treatments such as statins and more likely to be told they are “too young” to have heart disease, Bairey Merz said.

“These delays and dismissals have had serious consequences,” she said. “The Women’s Ischemia Syndrome Evaluation [WISE] study that I led for the National Heart, Lung, and Blood Institute helped us better understand that heart disease doesn’t always look the same in women. That insight ultimately pushed the field to rethink and improve how we diagnose and treat it.”

Despite these advances, women with heart disease are still more likely to be misdiagnosed, underdiagnosed or undertreated—sometimes delaying care that could save their lives.

“The good news is that heart disease is largely preventable,” Bairey Merz said. “And for women in particular—who may not experience obvious symptoms or whose symptoms are subtle—knowledge is a powerful prevention tool.”

To explain what women should watch for, the Cedars-Sinai Newsroom spoke with Bairey Merz about what women can do to protect their hearts and advocate for the healthcare they need.

What are some of the biggest myths about heart disease?

Many people believe that heart disease primarily affects men, that heart attacks always involve crushing chest pain, or that cancer is the top cause of death. In reality, heart disease kills more women than all cancers combined, yet fewer than half of women recognize it as their greatest health threat.

While men tend to develop cardiovascular disease earlier, women are more likely to experience poorer outcomes.

Why are heart attack rates increasing among younger women?

For decades, heart attack death rates declined sharply, thanks to improved research, standardized treatment guidelines, and widespread use of effective medications and procedures. While heart attack deaths are still much lower than they once were, the increase in heart problems among younger adults is concerning.

Researchers are looking into exact causes for the increase, but we know that contributing factors include low levels of physical activity and prolonged sedentary behavior, rising rates of diabetes and obesity, chronic stress, and environmental exposures such as air pollution.

What does a heart attack feel like for women?

The so-called “Hollywood heart attack”—tingling in the left arm that leads to sudden, crushing chest pain—is common in men and can occur in women as well. But many women experience subtler symptoms, including shortness of breath, nausea, unusual fatigue, back or jaw pain, or chest discomfort that doesn’t feel severe or dramatic.

Because these symptoms don’t match common expectations of a heart attack, they may be overlooked or dismissed. Anyone experiencing them should seek medical care immediately.

What causes heart attacks in women?

An increasing number of heart attacks are occurring in people without significant blockages in the major coronary arteries, a pattern seen more often in women. While men’s heart disease more commonly involves blockage in large arteries, women are more likely to experience dysfunction of the heart’s smaller blood vessels. This condition—called ischemia with no obstructive coronary artery disease [INOCA]—can cause reduced blood flow to the heart even when major arteries appear clear.

Even women who are physically fit can develop INOCA. In the past, if a woman had heart attack symptoms but a “normal” angiogram showing clear major arteries, her condition might not have been recognized. Continued awareness and ongoing education around INOCA are helping clinicians better diagnose and treat these patients.

What is a normal heart rate for women?

A normal resting heart rate for most adults is between 60 and 100 beats per minute, according to the American Heart Association. Because women’s hearts are typically smaller, their resting heart rate may run slightly higher than men’s. Women should consult their doctor if their resting heart rate is below 60 or above 100 beats per minute when not exercising.

How can women protect heart health and prevent heart disease?

Heart disease develops silently over decades. While heart disease can be managed with highly effective treatments, prevention is the most powerful strategy.

An estimated 80% of heart disease cases are preventable with lifestyle modifications. These include staying current with annual screenings and knowing cholesterol, blood pressure and blood sugar levels; exercising at least 30 minutes daily; breaking up prolonged sitting because a sedentary lifestyle is considered as strong a risk factor as smoking; managing stress; getting seven to nine hours of sleep; avoiding smoking; and following a nutritious diet.

A Mediterranean-style, largely plant-based diet rich in fruits, vegetables, nuts, beans, whole grains, olive oil and lean proteins is recommended. Parents are encouraged to help ensure their children make healthy food choices, too.

Heart health isn’t about deprivation. It’s about building lifelong habits that prevent disease before it starts.

Read more on the Cedars-Sinai Blog: High Blood Pressure—What Women Need to Know

Preclinical Study Targets ‘Zombie’ Cells

Senolytics—a class of drugs that reduce chronic inflammation and tissue damage in aging cells—are shown to eliminate 30% to 70% of “zombie” cells in the body. These zombie cells, known as senescent cells, stop dividing and don’t die, ultimately contributing to a host of diseases of aging, including cancer.

A preclinical study from Cedars-Sinai, published in Aging Cell, had three key findings:

• Senolytic drugs purge the most harmful cells, leaving less-harmful senescent cells behind.
• These remaining “senolytic-resistant” senescent cells can be activated into tissue-damaging senescent cells by infections and other factors in the environment of senescent cells.
• A new class of drugs, “senosensitizers,” can enable senolytics to eliminate these lurking senolytic-resistant “ticking time bomb” cells.

Investigators found that in laboratory mice treated with senolytic drugs, the remaining senescent cells were less inflammatory and damaging than the cells removed by the treatment. Researchers also found that these remaining senescent cells, when activated into tissue-damaging cells by an inflammatory environment, become more vulnerable to senolytics than those in a stable environment.

Based on their findings that infections can make senescent cells become susceptible to senolytics, study authors theorize that targeting senescent cells with newly developed senosensitizers—and then senolytics—might allow more senescent cells to be removed than when using senolytics alone. This could remove senolytic-resistant senescent cells and reduce the impact of infections in previously apparently healthy older people.

“This drug combination, which is still in the preclinical phase, has the potential to target senescent cancer cells that persist after radiation and chemotherapy and may later reemerge as more aggressive disease,” said James Kirkland, MD, PhD, director of the Center for Advanced Gerotherapeutics and senior author of the study.

Additional Cedars-Sinai authors include Masayoshi Suda, Tamar Tchkonia, Selim Chaib, Larissa Langhi Prata, Tamar Pirtskhalava and Nino Giorgadze.

Additional authors include Utkarsh Tripathi, Vagisha Kulshreshtha, Bryan T. Piatkowski, Allyson K. Palmer, Christina Inman, Nathan Gasek, Ming Xu, Kurt O. Johnson, Yi Zhu, Renuka Kandhaya-Pillai, Stefan G. Tullius, Saranya P. Wyles, Rambabu Majji, Hari Krishna Yalamanchili and David B. Allison.

Funding: This work was supported by NIH grants R37AG013925 (J.L.K., T.T.), R33AG061456 (J.L.K., T.T.), R01AG066679 (M.X.), R01AG076642 (M.X.), R01AG064165 (S.G.T.), R01AG087387 (Y.Z.), the Connor Fund (J.L.K., T.T.), Robert J. and Theresa W. Ryan (J.L.K., T.T.), HF-GRO-­23-­ 1199148-­ 3 (J.L.K.), HF-­ GRO-­ 23-­ 1199262-­ 27 (Y.Z., M.S.), the JSPS Grants-­ in-­ Aid for Scientific Research Fund for the Promotion of Joint International Research (Fostering Joint International Research) 23KK0295 (M.S.), the Yamada Science Foundation (M.S.), and USDA/ARS grant CRIS 3092-­ 51000-­ 065-­ 003S (H.K.Y.) and the Noaber Foundation (J.L.K.). U.T. was supported by an American Heart Association predoctoral fellowship (917775).

Cedars-Sinai Study Links GLP-1RA Drugs to Risk of Chronic Cough

Patients who take the widely used Type 2 diabetes and obesity medications known as glucagon-like peptide-1 receptor agonists (GLP-1RAs) appear to be at increased risk of developing chronic cough, according to a new multicenter study led by Cedars-Sinai and published in JAMA Otolaryngology – Head & Neck Surgery.

GLP-1RA medications, marketed under many brand names, work by stimulating insulin release from the pancreas, lowering blood sugar and slowing digestion. As a result, these drugs may help people with Type 2 diabetes manage their blood sugar and help people with obesity lose weight.

Investigators reviewed 10 years of electronic medical records with data on more than 2 million Type 2 diabetes patients at 70 healthcare organizations. They compared records of individuals prescribed a GLP-1RA drug with those who were prescribed a non-GLP-1RA drug to treat diabetes, and found that GLP-1RA use was associated with a significantly increased risk of new chronic cough.

“Further research is needed to confirm the existence, strength and mechanisms of the association between GLP-1RA drugs and chronic cough,” said Anca Barbu, MD, associate professor in the Jim and Eleanor Randall Department of Surgery and the study’s corresponding author. “However, our findings highlight the importance of physicians and care providers asking patients with new-onset chronic cough about possible GLP-1RA use, and for healthcare providers prescribing these medications to discuss chronic cough as a possible side effect.”

The other Cedars-Sinai author is Neelaysh Vukkadala, MD.

Additional authors include Tyler J. Gallagher, MD, MPH; Diego E. Razura, MD; Albert Li, BA; and Ian Kim, PhD. 

Bodily Fluid Changes Linked to Poor Heart Surgery Outcomes

Patients who lose or gain a significant amount of fluid after certain elective heart surgeries are more likely to be readmitted to the ICU, stay longer in the hospital or die than patients whose fluid levels remain stable, according to a new study from Cedars-Sinai. The findings, published in Anesthesia & Analgesia, could help improve patient care.

Investigators reviewed data on 2,557 patients who underwent nonemergency coronary artery bypass grafts, valve surgeries or a combination of the two. They calculated each patient’s total fluid intake (including oral and intravenous fluids and blood products) and output (including urine, stool and surgical drains), based on measurements taken in the operating room and in the ICU after surgery.

“It remains unclear whether changes in cumulative fluid balances above 1.5 liters on the day of ICU discharge actually cause adverse outcomes or are just associated with them,” said senior author Joseph Ebinger, MD, MS, associate professor of Cardiology and director of the Coronary Intensive Care Unit and Clinical Analytics in the Smidt Heart Institute at Cedars-Sinai. “Further study is called for. In the meantime, our findings suggest that greater attention to such variations may help improve outcomes for cardiac surgery patients.”

Other Cedars-Sinai authors are Abirami Kumaresan, George Gill, Jesse Navarrette, Tao Shen, Milad Sharifpour, Dominic Emerson, Joanna Chikwe and Susan Cheng.

Funding: This study was supported in part by a grant from the International Anesthesia Research Society and NIH grant: K23-HL153888. The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Different Immune Cell Types Correlate with Breast Cancer Survival

The quantities of specific types of immune cells that appear in and around a breast cancer tumor are correlated with the prognosis for the patient, according to a new study led by Cedars-Sinai. The findings have implications for use of immunotherapy in this disease, the second leading cause of cancer deaths among women in the U.S.

The study was published in the peer-reviewed journal iScience.

Investigators analyzed images from 12,285 female breast cancers, including estrogen-positive breast cancer, the most common type, in which cancer cells have a protein that binds to the hormone estrogen; estrogen-negative breast cancer, in which the cells lack this protein, was also studied.

Using artificial intelligence (AI), investigators calculated the percentages of different types of immune cells within the tumors, in nearby connective tissue (known as stroma) and in total for both areas. They examined the relationship between these percentages and the likelihood that the patient would die from breast cancer over a certain period of time after diagnosis. Two types of immune cells, CD8+ and CD20+, were found to be associated with a better prognosis in estrogen-positive breast cancer patients, whereas another cell type, CD163+, was associated with a poorer prognosis. CD8+ and FOXP3+ immune cells were associated with a better prognosis in estrogen-negative breast cancer.

“Our findings suggest that the immune system is an important predictor of outcome in hormone-positive breast cancer,” said Paul Pharoah, MD, PhD, professor of cancer epidemiology in the Department of Computational Biomedicine at Cedars-Sinai and the study’s senior and corresponding author. “They support including this subset of patients in clinical trials of immune modulators, which could lead to improved treatments for women with this common cancer.”

Other authors include: Aaron J. Bernstein PhD, Renske Keeman MSc, Amber Hurson PhD, Fiona M. Blows PhD, Manjeet K. Bolla MSc, Jodi L. Miller PhD, Roger L. Milne PhD, Hugo Horlings MD, PhD, Alexandra J. van den Broek PhD, Clara Bodelon PhD, James M. Hodge JD, MPH, Alpa V. Patel PhD, Lauren R. Teras PhD, Federico Canzian PhD, Rudolf Kaaks PhD, Hermann Brenner MD, Ben Schöttker PhD, Sabine Behrens PhD, Jenny Chang-Claude PhD, Tabea Maurer DiplPsych, Nadia Obi PhD, Fergus J. Couch PhD1, H. Raza Ali PhD, Carlos Caldas MD, Irene Andrulis PhD, Gord Glendon MSc, Anna Marie Mulligan MD, Wilma Mesker PhD, Agnes Jager MD, PhD, Annette Heemskerk-Gerritsen PhD, Peter Devilee PhD, Scott M. Lawrence PhD, Jolanta Lissowska PhD, Karun Mutreja PhD, Thomas Ahearn PhD, Stephen Chanock MD, Maire A. Duggan MD, Diana Eccles PhD, J. Louise Jones MB ChB, PhD, Will Tapper PhD, Antoinette Hollestelle PhD, Maartje Hooning PhD, John Martens PhD, Carolien H.M. van Deurzen MD, PhD, Angela Cox PhD3, Simon S. Cross MB BS, Mikael Hartman MD, PhD, Jingmei Li PhD, Thomas C. Putti MD, Ute Hamann PhD, Muhammad Rashid MB BS, PhD, Ania Jakubowska PhD, Nicki Camp PhD, Melissa H. Cessna MD, Amy Berrington de Gonzalez DPhil, Katarzyna Bialkowska PhD, Jacek Gronwald PhD, Jan Lubiński MD, PhD, Siddhartha Yadav MD, Pietro Lio PhD, Doug F. Easton PhD, Mustapha Abubakar MD, PhD, Montse Garcia-Closas MD, DrPH,  and Marjanka K. Schmidt, PhD.

Acknowledgements: The authors thank the Histology and Genomics Cores at the Cancer Research UK Cambridge Institute for technical support, and all patients, researchers, clinicians, and administrative personnel who contributed to the studies taking part in BCAST.  The CPSII study investigators acknowledge the contribution to this study from central cancer registries supported through the Centers for Disease Control and Prevention's National Program of Cancer Registries and cancer registries supported by the National Cancer Institute's Surveillance Epidemiology and End Results Program.

BCAC was supported by Cancer Research UK grant: PPRPGMNov20\100002 and by core funding from the NIHR Cambridge Biomedical Research Centre (NIHR203312). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.  The BCAST project was supported by the Horizon 2020 Research and Innovation Programs of the European Union B (grant number: 633784) and the NIHR Cambridge Biomedical Research Centre. AJB was supported by the NIH Oxford-Cambridge Scholars and Gates Cambridge Scholars programs. (The funding of the contributing studies is listed in a supplementary table in the article.)

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

“Los incendios forestales que se extienden a las zonas urbanas han demostrado ser extremadamente peligrosos debido a la rapidez con la que se propagan y a lo que queman y liberan al medio ambiente,” afirmó la Dra. Susan Cheng, vicepresidenta de Investigación del Departamento de Cardiología del Smidt Heart Institute y autora principal del estudio, publicado en JACC. “Nuestra investigación sugiere que los incendios de Eaton y Pacific Palisades tuvieron un efecto inmediato en la salud de las personas.”

El Departamento de Emergencias de Cedars-Sinai se encuentra en el campus principal del centro académico, a unos 24 km de Pacific Palisades y a unos 40 km de Altadena, los lugares donde se iniciaron los mayores incendios de Los Ángeles en enero de 2025. Los investigadores recopilaron datos sobre las visitas al servicio de urgencias durante los 90 días posteriores al inicio de los incendios, desde el 7 de enero hasta el 7 de abril de 2025. Compararon estos datos con los datos de visitas a urgencias recopilados durante el mismo periodo calendario en los años 2018 a 2024.

Aunque no hubo una diferencia significativa en el total de visitas a urgencias durante los primeros 90 días tras el inicio de los incendios forestales en 2025, se produjo un aumento drástico de las visitas a urgencias por determinadas afecciones. Los investigadores observaron un aumento del 118 % en las visitas por enfermedades generales, un aumento del 46 % en el número de visitas a urgencias por infarto de miocardio y un aumento del 24 % en las visitas por enfermedades pulmonares, en comparación con la tasa media de estas afecciones diagnosticadas durante el mismo periodo en los últimos siete años.

“Las partículas finas liberadas por los incendios forestales pueden entrar en el cuerpo y causar lesiones, especialmente en el corazón y los pulmones,” afirmó Cheng, que también es titular de la cátedra Erika J. Glazer de Salud Cardiovascular y Ciencias de la Población en el Instituto Cardiológico Smidt de Cedars-Sinai. “El estrés relacionado con los incendios también puede contribuir a una amplia gama de problemas de salud.”

Los investigadores descubrieron que los resultados anormales de los análisis de sangre relacionados con enfermedades generales se duplicaron con creces en el periodo de 90 días de 2025 en comparación con el mismo periodo de años anteriores. Según los investigadores, se trata de un hallazgo que no se había descrito anteriormente tras grandes incendios forestales.

“Los resultados anormales de los análisis de sangre podrían indicar que el cuerpo está respondiendo a un factor de estrés externo, como las toxinas presentes en el aire,” afirmó el Dr. Joseph Ebinger, profesor asociado del Departamento de Cardiología y primer autor del estudio. “Este estudio es un paso importante para comprender cómo los incendios de Palisades y Eaton pueden haber afectado a la salud de los angelinos. Necesitamos más investigación para determinar qué podemos hacer para mitigar los riesgos restantes y proteger a las personas de los daños causados por los incendios en el futuro.”

Este estudio forma parte del estudio más amplio LA Fire HEALTH Study, una colaboración de investigación que busca determinar los efectos sobre la salud de los incendios que se iniciaron en enero de 2025 en el condado de Los Ángeles. Investigadores del Cedars-Sinai, la Escuela de Salud Pública T.H. Chan de Harvard, la Escuela de Medicina Keck de la Universidad del Sur de California (USC), la Universidad de Stanford, la UCLA, la Universidad de California en Davis (UCD), la Universidad de California en Irvine (UCI), la Universidad de Texas en Austin y la Universidad de Yale tienen previsto estudiar los efectos de los incendios durante los próximos 10 años.

Autores adicionales de Cedars-Sinai son Tzu Yu Huang, MS; Sandy Joung, MSHS, MBA; Juliane Kwong, BS; Wasay Warsi, MS, BS; Nancy Sun, MPS; Jesse Navarrette, MPA; Patrick Botting, DHSc; Zaldy S. Tan, MD, MPH; y Alan C. Kwan, MD.

Otros autores son Brian L. Claggett, PhD, del Brigham and Women’s Hospital de Boston.

Financiación. Este trabajo ha sido financiado en parte por el Spiegel Family Fund, la Smidt Heart Foundation y la Erika J. Glazer Family Foundation.

Cedars-Sinai Health Sciences University impulsa investigaciones innovadoras y forma a los futuros líderes en medicina, ciencias biomédicas y ciencias de la salud aliadas. Conozca más sobre la universidad.

“Wildfires that spread into urban areas have proven to be extremely dangerous because of how quickly they move and what they burn and release into the environment,” said Susan Cheng, MD, MPH, vice chair of Research Affairs in the Department of Cardiology in the Smidt Heart Institute and senior author of the study, published in JACC. “Our research suggests the Eaton and Pacific Palisades fires had an immediate effect on people’s health.”

The Cedars-Sinai Emergency Department is located on the academic medical center’s main campus, about 10 miles from Pacific Palisades and about 20 miles from Altadena, the locations where the largest L.A. fires ignited in January 2025. Investigators collected data on emergency department visits during the 90 days after the fires started, from Jan. 7 to April 7, 2025. They compared this data with emergency visit data collected during the same calendar period in the years 2018 through 2024. 

Although there wasn’t a significant difference in total emergency department visits during the first 90 days following the start of the wildfires in 2025 as compared with other years, there was a drastic increase in emergency department visits for certain conditions. Investigators found a 118% increase in visits for general illness, 46% increase in the number of visits for heart attack, and a 24% increase in visits for pulmonary illness when compared to the average rate of these conditions diagnosed during the same time window in the past seven years. 

“Fine particles released by wildfires can enter the body and cause injury, particularly to the heart and lungs,” said Cheng, who is also the Erika J. Glazer Chair in Cardiovascular Health and Population Science in the Smidt Heart Institute at Cedars-Sinai. “Stress related to the fires may also contribute to a broad range of health issues.” 

The investigators found that abnormal blood test results related to general illness more than doubled in the 90-day period in 2025 as compared with that period in previous years. This is a finding not previously reported after major wildfires, according to the investigators.

“Abnormal blood test results could indicate that the body is responding to an external stressor such as toxins in the air,” said Joseph Ebinger, MD, MS, associate professor in the Department of Cardiology and first author of the study. “This study is an important step toward understanding how the Eaton and Palisades fires may have affected Angelenos’ health. We need more research to determine what we can do to mitigate any remaining risks and protect people from fire harm in the future.” 

This study is part of the larger LA Fire HEALTH Study, a research collaboration that seeks to determine the health effects of the fires that ignited in January 2025 in L.A. County. Investigators with Cedars-Sinai; the Harvard T.H. Chan School of Public Health; the Keck School of Medicine of the University of Southern California (USC); Stanford University; UCLA; the University of California, Davis (UCD); the University of California, Irvine (UCI); the University of Texas at Austin; and Yale University plan to study the impacts of the fires for the next 10 years. 

Additional Cedars-Sinai authors include Tzu Yu Huang, MS; Sandy Joung, MSHS, MBA; Juliane Kwong, BS; Wasay Warsi, MS, BS; Nancy Sun, MPS; Jesse Navarrette, MPA; Patrick Botting, DHSc; Zaldy S. Tan, MD, MPH; and Alan C. Kwan, MD.

Other authors include Brian L. Claggett, PhD, of Brigham and Women’s Hospital in Boston.

Funding: This work was partially supported by the Spiegel Family Fund, the Smidt Heart Foundation, and the Erika J. Glazer Family Foundation. 

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

“Los habitantes de California esperan que cumplamos la promesa de la terapia celular y génica utilizando los fondos públicos, una responsabilidad que tomamos muy en serio”, dijo Eduardo Marbán, MD, PhD, director ejecutivo del Smidt Heart Institute de Cedars-Sinai. “Con estas subvenciones, trabajaremos para llevar nuevas terapias a los pacientes con enfermedades del corazón."

Esperanza para la insuficiencia cardíaca

Una de las subvenciones, de más de $10 millones, permitirá que los investigadores de Cedars-Sinai dediquen los próximos cinco años a estudiar un tratamiento para una forma común de insuficiencia cardíaca llamada insuficiencia cardíaca con fracción de eyección preservada.

Más de 6 millones de adultos en EE.UU. viven con insuficiencia cardíaca, que ocurre cuando el corazón no bombea suficiente sangre para satisfacer las necesidades del cuerpo. En la insuficiencia cardíaca con fracción de eyección preservada, el tipo más común, el corazón está demasiado rígido para llenarse adecuadamente de sangre. Esta condición causa la muerte en más de la mitad de las personas que la desarrollan, y no existen medicamentos que detengan su progresión o prolonguen la vida de los pacientes.

David Lefer, PhD, director de Investigación Traslacional en el Departamento de Cirugía Cardíaca del Smidt Heart Institute, liderará estudios preclínicos para investigar un nuevo fármaco de ARN, TY1, combinado con el medicamento para la pérdida de peso semaglutida, como un enfoque más efectivo para tratar esta enfermedad. Los investigadores esperan iniciar ensayos clínicos en los próximos años.

“La obesidad es un factor de riesgo importante para la insuficiencia cardíaca con fracción de eyección preservada”, dijo Lefer. “Esperamos que crear un tratamiento que combine los beneficios de un fármaco GLP-1 con los efectos inmunomoduladores del exómero de ARN TY1 pueda reducir el riesgo de muerte por insuficiencia cardíaca."

Nueva investigación sobre una causa de muerte cardíaca súbita

Una segunda subvención de CIRM proporcionará más de $10 millones durante cinco años para que investigadores de Cedars-Sinai estudien la miocardiopatía arritmogénica (ACM), una enfermedad cardíaca hereditaria poco frecuente. La ACM es la principal causa de muerte cardíaca súbita en atletas y jóvenes, y no existen medicamentos que detengan su progresión. Los fondos apoyarán estudios preclínicos y de seguridad de un nuevo fármaco que podría detener la enfermedad e incluso revertir el daño que causa al corazón.

“Muchas personas no saben que tienen ACM hasta que presentan un paro cardíaco o insuficiencia cardíaca," dijo Alessandra Ciullo, PhD, científica del Smidt Heart Institute. “Queremos ofrecer a esos pacientes un tratamiento que revierta la enfermedad y prolongue sus vidas."

Las subvenciones de CIRM han apoyado varios estudios en el Smidt Heart Institute, incluyendo investigaciones sobre un posible tratamiento para la taquicardia ventricular y una terapia celular para la hipertensión arterial pulmonar.

Cedars-Sinai Health Sciences University impulsa investigaciones innovadoras y forma a los futuros líderes en medicina, ciencias biomédicas y ciencias de la salud aliadas. Conozca más sobre la universidad.

AI Framework Speeds Up Brain Neuron Modeling

Cedars-Sinai investigators worked with a multi-institutional team to develop a new artificial intelligence framework that can accurately, quickly and efficiently create virtual models of brain neurons. The achievement could accelerate discoveries in brain function research and ultimately lead to better treatments for brain disorders.

The study’s findings were presented at the 39th Conference on Neural Information Processing Systems in San Diego.

“Computational modeling of brain neurons has become an important tool for studying their activity and interactions,” said co-author Costas Anastassiou, PhD, associate professor of Neurology, Neurosurgery and Biomedical Sciences at Cedars-Sinai. “But traditional models are hindered by limitations including the cost of computer resources, data availability and cumbersome handling. Our new framework tackles this problem by operating at speeds thousands of times faster than existing methods while remaining so biologically accurate that it can capture the variability of actual brain neurons, unlike current approaches. The framework can also generate an unlimited number of virtual neurons, better reflecting the diversity and variability of actual biological neurons.”

Anastassiou added that the framework opens a pathway toward modeling larger-scale brain circuits that could improve understanding of the relationships between gene expression, electrical activity and networking in neurons. The investigators named their invention NOBLE, for Neural Operator with Biologically-informed Latent Embeddings.

“I am very happy to see this interdisciplinary and inter-institutional collaboration,” said Anima Anandkumar, PhD, Bren Professor of Computing and Mathematical Sciences at Caltech and a co-author of the study. “Neural operators are designed to capture the complex dynamics seen in biological neurons, and this is the first large-scale AI framework validated with experimental human cortex data.”

The additional Cedars-Sinai author is Philip H. Wong.

Other authors include Luca Ghafourpour, Valentin Duruisseaux, and Bahareh Tolooshams.

Funding: A.A. is supported by the Bren Endowed Chair, ONR (MURI grant N00014-23-1-2654), and the AI2050 Senior Fellow program at Schmidt Sciences. C.A.A. is supported by the National Institutes of Health R01 - NS120300 and R01 - NS130126. P.H.W. is supported by the National Institutes of Health R01 - NS130126.

Liver Cancer Prevention, Treatment Efforts Are Working

Prevention and treatment advances are reducing the number of new liver cancer patients and narrowing survival gaps among racial groups, a Cedars-Sinai Cancer study published in the journal Clinical Gastroenterology and Hepatology reports.

“We found that liver cancer rates in the U.S. have begun to decline after many years of increase, and deaths from liver cancer have stabilized,” said Ju Dong Yang, MD, medical director of the Liver Cancer Program at Cedars-Sinai and senior author of the study. “Younger patients and those with advanced disease are living longer, partly due to new therapies. And differences in survival rates between Black and white patients have nearly disappeared, suggesting that fairer access to care and treatment advances are helping reduce longstanding racial disparities.”

Investigators looked at data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results cancer registry on newly diagnosed liver cancer cases, tumor stage at diagnosis, treatment trends, and survival rates in the U.S. over the past two decades. Despite declining liver cancer rates and improved overall survival, they found that early detection and curative treatment decreased during the COVID-19 pandemic. Investigators suggest this highlights the importance of strengthening screening and care access during healthcare disruptions.

Additional Cedars-Sinai authors include Yi-Te Lee, Hyun-seok Kim, Alexander Kuo, Walid S. Ayoub, Hirsh D. Trivedi, Yun Wang, Aarshi Vipani, Paul Martin, and Cristina R. Ferrone.

Other authors include Jasmine J. Wang, Pojsakorn Danpanichkul, and Amit G. Singal.

Funding: Dr. Singal’s research is funded by National Institutes of Health R01CA256977 and R01 MD012565. Dr. Yang’s research is supported by National Institutes of Health K08CA259534; R21CA280444.

Disclosures: Dr. Yang provides a consulting service for AstraZeneca, Eisai, Exact Sciences, Exelixis, Fujifilm Medical Sciences, Merck, and Gilead Sciences.

New AI Tool Improves Heart Test Evaluation

A new AI tool can rapidly evaluate data from echocardiography, an imaging test commonly used to diagnose heart disease, according to new research led by Cedars-Sinai. The study, published in JACC, found the tool could speed up the testing process and yield more uniform results.

The AI system automatically takes 18 different measurements during echocardiography, which uses high-frequency sound waves to create moving pictures of the heart and evaluate blood flow. The procedure is used to assess signs and symptoms of heart failure, atherosclerosis, cardiomyopathy and other conditions.

“Our AI tool demonstrated accuracy and precision comparable to that of expert sonographers from two medical institutions,” said David Ouyang, MD, assistant professor in the Department of Cardiology in the Smidt Heart Institute at Cedars-Sinai and corresponding author of the study. “One of the primary benefits of automation is that it reduces examination time and produces more consistent readings.”

Ouyang added that more testing is needed before the tool is used for patients.

Additional Cedars-Sinai authors include Yuki Sahashi, Victoria Yuan, Matthew Christensen, Milos Vukadinovic and Christina Binder-Rodriguez.

Additional authors include Hirotaka Ieki, Justin Rhee, James Y. Zou, Bryan He and Paul Cheng.

Funding: This work was funded by National Institutes of Health, National Heart, Lung, and Blood Institute grants R00HL157421, R01HL173526, and R01HL173487.

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

Cedars-Sinai scientists have developed an experimental drug that repairs DNA and serves as a prototype for a new class of medications that fix tissue damage caused by heart attack, inflammatory disease or other conditions.

Investigators describe the workings of the drug, called TY1, in a paper published in Science Translational Medicine.

“By probing the mechanisms of stem cell therapy, we discovered a way to heal the body without using stem cells,” said Eduardo Marbán, MD, PhD, executive director of the Smidt Heart Institute at Cedars-Sinai and the study’s senior author. “TY1 is the first exomer—a new class of drugs that address tissue damage in unexpected ways.”

TY1 is a laboratory-made version of an RNA molecule that naturally exists in the body. The research team was able to show that TY1 enhances the action of a gene called TREX1, which helps immune cells clear damaged DNA. In so doing, TY1 repairs damaged tissue.

The development of TY1 has been more than two decades in the making. It started when Marbán’s previous laboratory at Johns Hopkins University developed a technique to isolate progenitor cells from the human heart. Like stem cells, progenitor cells can turn into new healthy tissue, but in a more focused manner than stem cells. Heart progenitor cells promote the regeneration of the heart, for example.

Later, at Marbán’s lab at Cedars-Sinai, Ahmed Ibrahim, PhD, MPH, discovered that these heart progenitor cells send out tiny molecule-filled sacs called exosomes. These sacs are loaded with RNA molecules that help repair and regenerate injured tissue.

“Exosomes are like envelopes with important information,” said Ibrahim, who is associate professor in the Department of Cardiology in the Smidt Heart Institute and first author of the paper. “We wanted to take apart these coded messages and figure out which molecules were, themselves, therapeutic.”

Scientists genetically sequenced the RNA material inside the exosomes. They found that one RNA molecule was more abundant than the others, hinting it might be involved in tissue healing. The investigators found the natural RNA molecule to be effective in promoting healing after heart attacks in laboratory animals. TY1 is the synthetic, engineered version of that RNA molecule, designed to mimic the structure of approved RNA drugs already in the clinic. TY1 works by increasing the production of immune cells that reverse DNA damage, a process that minimizes the formation of scar tissue after a heart attack.

“By enhancing DNA repair, we can heal tissue damage that occurs during a heart attack,” Ibrahim said. “We are particularly excited because TY1 also works in other conditions, including autoimmune diseases that cause the body to mistakenly attack healthy tissue. This is an entirely new mechanism for tissue healing, opening up new options for a variety of disorders.”

The investigators next plan to study TY1 in clinical trials. 

Other Cedars-Sinai authors include Alessandra Ciullo, Hiroaki Komuro, Kazutaka Miyamoto, Xaviar M. Jones, Shukuro Yamaguchi, Kara Tsi, Jessica Anderson, Joshua Godoy Coto, Diana Kitka, Ke Liao, Chang Li, Alice Rannou, Asma Nawaz, Ashley Morris, Cristina H. Marbán, Jamie Lee, Nancy Manriquez, Yeojin Hong, Arati Naveen Kumar, James F. Dawkins, and Russell G. Rogers.

Funding: This work was supported by National Heart, Lung, and Blood Institute grants R01 HL164588 and T32 HL116273, and R01 HL142579. This work was also supported by the California Institute for Regenerative Medicine grant TRAN1-15317.

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

Preclinical Study: Protecting Against Diabetic Corneal Disease

The medical journal Diabetologia recently published a Cedars-Sinai study that helps explain why half of diabetes patients experience deterioration of the cornea, the transparent dome-shaped outer layer of the eye that provides protection and focuses incoming light. The findings point to a potential target for therapies to protect vision in these patients.

Investigators performed experiments comparing diabetic versus nondiabetic human corneal cells to explain the molecular changes that diabetes patients experience. Diabetic corneal disease can lead to delayed wound healing and loss of vision.

“Our findings highlight the major role of a molecule called microRNA-10b in the oxidative stress characteristic of diabetic corneal disease and the damage it causes to cells,” said Mehrnoosh Ghiam, PhD, associate professor of Biomedical Sciences, research scientist in the Board of Governors Regenerative Medicine Institute and senior author of the study. “Inhibiting this molecule restored the cornea’s defenses against oxidative stress and cell damage and allowed the outermost layer of cells to be maintained and renewed.”

Additional Cedars-Sinai authors include Daxian Zha, Joshua Gamez, Shaghaiegh M. Ebrahimi, Yizhou Wang, Nagendra Verma, Adam J Poe, Seok White, Ruchi Shah, Andrei A. Kramerov, Chintda Santiskulvong, Aleksandr B. Stotland, Zhiping P. Wang, Jennifer E. Van Eyk, and Alexander V. Ljubimov.

Other authors include Onkar B. Sawant.

Funding: This work was supported by grants from the National Institutes of Health R01 EY025377 (MS); R01EY029829 (MS); R01EY031377 (AVL), R01EY013431 (AVL); the California Institute for Regenerative Medicine (CIRM EDUC4-12751); and funding from the Board of Governors Regenerative Medicine Institute (MS).

Cedars-Sinai Study Highlights AI Limits in Heart Care

There are limits in applying AI to images of the heart, a new study from the Smidt Heart Institute at Cedars-Sinai reveals. The findings were published in the Journal of the American Society of Echocardiography.

Investigators trained multiple artificial intelligence models to read images from echocardiograms, a type of ultrasound test that evaluates the structure and function of the heart. Their goal was to determine whether AI could use these images to calculate measurements like inflammation and scarring that are normally obtained through another, more costly test called cardiac magnetic resonance imaging (CMRI). By examining findings from1,453 patients who had undergone both tests, they found the AI models could not accomplish this task.

“As compared to echocardiograms, cardiac MRI machines are expensive and not available for many patients, especially those in rural areas, so we had hoped that AI could reduce the need for it,” said Alan Kwan, MD, assistant professor in the Department of Cardiology in the Smidt Heart Institute at Cedars-Sinai and co-senior author of the study. “Our results showed the limited powers of AI in this area.”

Other Cedars-Sinai investigators include: Yuki Sahashi, MD, MSc; Milos Vukadinovic, BS; Grant Duffy, BS; Debiao Li, PhD; Susan Cheng, MD, MMSc, MPH; Daniel S. Berman, MD; and David Ouyang, MD (co-senior author).

Acknowledgments: This work was supported in part by grants from the American Heart Association (23CDA1053659), the NIH (KL2TR001882), (75N92020D00021), the NHLBI (R00HL157421), (75N92020D00021, the NBIB through the Medical Imaging and Data Resource Center (MIDRC), Japanese Society of Echocardiography (Foreign research grant), and Japanese Society for the Promotion of Science, Grants-in-Aid for Scientific Research (JSPS-KAKENHI). No funders had a role in the design/conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Competing interests: ACK reports support from the American Heart Association (AHA; 23CDA1053659) and National Institutes of Health (NIH; KL2TR001882), and consulting fees from InVision Medical Technology. DO reports support from the National Institute of Health (NIH; NHLBI R00HL157421) and Alexion, and consulting or honoraria for lectures from EchoIQ, Ultromics, Pfizer, InVision, the Korean Society of Echo, and the Japanese Society of Echo. YS reports honoraria for consulting from m3.com inc.

Racial Differences and Prostate Cancer Treatment Decisions

Black men choose aggressive prostate cancer treatment—regardless of anticipated life expectancy—more often than Hispanic or Caucasian men, according to new research by Cedars-Sinai investigators published in the journal Prostate Cancer and Prostatic Diseases.

In the study, more than 2,000 men selected to mimic the sociodemographics of the U.S. prostate cancer population were asked to choose between conservative management and aggressive treatment in various prostate cancer diagnosis scenarios. These scenarios required participants to make treatment choices in the setting of different risks of cancer death and side effects, all while considering their anticipated life expectancy. Life expectancy is important because prostate cancer is typically slow-growing, and treatment only benefits men with relatively long life expectancies. Among Hispanic and Caucasian men, lower life expectancy was associated with lower likelihood of choosing aggressive treatment. Black men consistently elected to pursue aggressive treatment regardless of life expectancy. This pattern may put Black men at higher risk for overtreatment.

Timothy J. Daskivich, MD, director of Academic Urologic Oncology for the Department of Urology at Cedars-Sinai and corresponding author of the study, said more research is needed to determine why Black men routinely chose aggressive treatment.

“We have to be aware of cultural differences that may make different groups of patients pursue treatment for different reasons,” Daskivich said. “It’s important to have a holistic view and to understand patients’ motivations for making the decisions they do so that we can provide the best possible care.”

Additional Cedars-Sinai authors include John M. Masterson, Rebecca Gale, Brennan Spiegel and Stephen J. Freedland.

Other authors include Renning Zheng, Michael Luu, Adam Murphy, Yaw A. Nyame and Chad Ritch.

Funding: NIH/NCI K08 CA230155; Open access funding provided by SCELC, Statewide California Electronic Library Consortium.

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

Eduardo Marbán, MD, PhD, executive director of the Smidt Heart Institute at Cedars-Sinai, will give the George E. Brown Memorial Lecture at the American Heart Association Scientific Sessions 2025 in November in New Orleans. The Association created this lecture in 1935 to honor the memory of clinician and researcher George E. Brown, MD, and every year selects a distinguished scientist to share advances in cardiovascular science. Marbán will present “Discovery Arc From Cell Therapy to Novel Noncoding RNA Drugs.” Marbán’s laboratory was the first to isolate and culture human heart cells capable of repairing damaged tissue.

Also at Scientific Sessions, Jennifer Van Eyk, PhD, director of Basic Science Research in the Barbra Streisand Women’s Heart Center, will be honored with the 2025 Council on Basic Cardiovascular Sciences Distinguished Achievement Award.

Van Eyk, the Erika J. Glazer Chair in Women’s Heart Health, is an international expert in clinical proteomics, the study of proteins in the body and how diseases affect those proteins. Her work has shown that proteins surpass genes as a source of real-time insights on what’s happening—and what is going to happen—inside the body. Much of her research focuses on how heart disease affects men and women differently at the molecular level.

“It is a privilege to see Dr. Van Eyk honored by the Association for nearly three decades of work in cardiovascular research,” said Marbán, the Mark Siegel Family Foundation Distinguished Chair. “This recognition reflects her profound impact on science and patient care, and we commend her for her commitment to excellence as she continues to pioneer earlier detection for conditions such as cardiovascular disease.”

Among Van Eyk’s most recent efforts is the development of remote blood sampling, which allows people to mail in samples for analysis and leads to faster, more personalized health assessments.

“This award highlights the incredible progress we’ve made in using proteomics to understand heart disease,” said Van Eyk, director of the Advanced Clinical Biosystems Research Institute and professor of Cardiology, Biomedical Sciences and Pathology and Laboratory Medicine. “By studying proteins, we’re moving closer to detecting conditions like heart failure before symptoms appear. Our goal is to make early diagnosis as simple as mailing in a blood sample.”

Ananth Karumanchi, MD, professor of Medicine and director of the Renovascular Research Center, is the recipient of the Association’s 2025 Excellence Award for Hypertension Research—one of the highest honors in the field. Karumanchi, the Medallion Chair in Vascular Biology, received the Excellence Award for Hypertension Research at the American Heart Association Hypertension Scientific Sessions in September in Baltimore. The award honors scientists whose work has significantly advanced understanding and treatment of high blood pressure and related conditions.

Karumanchi’s work focuses on hypertension during pregnancy. His particular focus is preeclampsia, a serious blood pressure condition that can be fatal and increases a woman’s risk of heart disease, heart failure and stroke later in life. He is currently leading an international team studying how the placenta impacts heart health in mothers and infants. The project builds on Karumanchi’s earlier work, which pinpointed a protein in the blood that could help doctors detect preeclampsia earlier.

“I’m honored to have received this award from the American Heart Association,” Karumanchi said. “It underscores the dedication of our team as we work to better understand and treat hypertension and preeclampsia and improve cardiovascular health for mothers and babies.”

Jiun-Ruey Hu, MD, MPH, a fellow in interventional and structural cardiology in the Department of Cardiology, has also been selected as an Association award recipient. He will be recognized at this year’s Scientific Sessions as the winner of the 2025 Kidney in Cardiovascular Disease Educational Tools Contest.

Hu mentored a medical student (Sara Pollanen) in creating a digital tool to help clinicians treat patients with cardiorenal syndrome, a complex condition involving the heart and kidneys. Hu previously won the award from the Association in 2022 while completing his first fellowship at the Yale School of Medicine.

“The Cedars-Sinai Health Sciences University congratulates our faculty members on their well-deserved recognition from the American Heart Association,” said Shlomo Melmed, MB, ChB, executive vice president of Medicine and Health Sciences and dean of the Medical Faculty. “Their prestigious honor awards and novel discovery presentations reflect the finest in cardiovascular science and clinical care.” 

The 2025 Scientific Sessions meeting is chaired by Joanna Chikwe, MD, the Irina and George Schaeffer Distinguished Chair in Cardiac Surgery in the Smidt Heart Institute.

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

Raj Makkar, MD, an interventional cardiologist in the Department of Cardiology in the Smidt Heart Institute, is senior author of a study published in The New England Journal of Medicine that describes the Phase III clinical trial results.

“These results show that seven years after treatment, health outcomes for patients were similar whether they underwent a minimally invasive procedure or open-heart surgery,” said Makkar, the inaugural director of the Karsh Division of Interventional Cardiology at Cedars-Sinai.

Aortic valve disease affects about 2% of the U.S. population, and risk rises with age, so the disorder is expected to become increasingly common.

The international PARTNER 3 trial involved 1,000 patients at 71 healthcare locations. Study participants had a severe form of aortic valve stenosis, a condition in which the heart’s aortic valve becomes so narrow and stiff that it cannot open fully to allow blood to pass through. The condition can cause heart failure or stroke.

Clinical trial participants were randomly chosen to undergo either open-heart surgery or a procedure called a transcatheter aortic valve replacement, also known as TAVR. All participants received a commercially available bioprosthetic valve called the SAPIEN 3 valve.

During TAVR, an interventional cardiologist threads a catheter through an artery to reach the heart and replace the diseased valve. Previous randomized controlled trials, including an earlier version of PARTNER 3, reported similar outcomes with TAVR and surgery five years after treatment in people with low to high risk for surgical complications.

For this study, investigators limited participation to patients considered to be at low surgical risk. Seven years after treatment, composite rates of death, stroke or rehospitalization related to treatment were 34.6% for TAVR (496 people) and 37.2% for surgery (454 people), a difference that was not statistically significant. The rates of failure for the bioprosthetic valve were similar: 6.9% for TAVR and 7.3% for surgery. In addition, patients in both groups reported comparable quality of life outcomes.

“These rich data exemplify the vital information clinicians need to guide patient treatment,” said Eduardo Marbán, MD, PhD, executive director of the Smidt Heart Institute and the Mark Siegel Family Foundation Distinguished Chair. “We are proud to offer leading-edge clinical care while also advancing the field of cardiology with groundbreaking research.”

The Smidt Heart Institute is a global leader in treating heart valve disease surgically and with transcatheter procedures. Makkar, vice president of Cardiovascular Innovation and Intervention, leads a team of interventional cardiologists who perform almost 800 TAVRs each year.

The investigators next plan to report patient outcomes and valve durability at 10 years posttreatment.

Other authors include Martin B. Leon, MD; Michael J. Mack, MD; Philippe Pibarot, DVM, PhD; Rebecca T. Hahn, MD; Vinod H. Thourani, MD;   S.H. Kodali, MD; Philippe Genereux, MD;  Samir R. Kapadia, MD; David J. Cohen, MD, MSc; Stuart J. Pocock, PhD; Yiran Zhang, MS; Molly Szerlip, MD; Julien Ternacle, MD, PhD; S. Chris Malaisrie, MD; Howard C. Herrmann, MD; Wilson Y. Szeto, MD; Mark J. Russo, MD; Vasilis Babaliaros, MD; Tamim Nazif, MD; John G. Webb, MD.

The study was funded by Edwards Lifesciences. Makkar receives research grants and travel support from Edwards Lifesciences.

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

“I knew something wasn't right, and the best thing to do was to sit down so that I could get the medical attention I needed,” said King, a defender for Angel City FC (ACFC).

During that infamous match, King stood up to kick a ball that was passed to her but slowly went down again. Next, everything went black. King was having a heart attack at 20.

ACFC medical team, including Cedars-Sinai physicians Tracy Zaslow, MD, primary care sports medicine specialist, and Rachel Triche, MD, orthopaedic surgeon and chief medical officer for the team, rushed the field with ACFC head athletic trainer Hollie Walusz, who performed lifesaving CPR that prevented permanent heart damage. King was transported to Cedars-Sinai, where she underwent emergency surgery to correct a heart defect she didn’t know she had.

It was a dramatic turn of events for a woman who started playing soccer at 10, declared at 12 she wanted to play professionally, and was selected with the second overall pick in the 2024 National Women's Soccer League draft at 18. A year later, she joined ACFC. 

King is one of millions of people who undergo heart surgery every year and face a long recovery.

“This is the first major injury I’ve had, so it’s been a lot of me figuring things out,” she said. “Having a huge support system has been the biggest thing and also being able to just feel all the emotions I'm feeling.”

When Cedars-Sinai cardiologist Seth Lichtenstein, MD, reviewed CT scans of King’s heart, he discovered one of the large arteries that feeds blood to the heart was showing an extremely narrow opening—like a road that was nearly blocked off.

“Her left coronary artery was so narrow that it was unable to deliver blood to the heart effectively,” Lichtenstein said.

Lichtenstein diagnosed King with an anomalous left coronary artery, a rare condition that fewer than 1% of people are born with. Most people with an anomalous artery don’t learn about their condition until they have symptoms so severe that a doctor orders imaging or when they have imaging for an unrelated reason. The type of anomaly that King had is the kind that typically requires surgery.

“This congenital lesion can be especially dangerous,” said Richard W. Kim, MD, director of Pediatric and Congenital Heart Surgery at Cedars-Sinai. “It can lead to a heart attack, stroke, heart failure, or even sudden death.”

Kim led the team of doctors who performed the surgery, creating a new pathway for the blood to get to the artery.

Next came King’s recovery. After six weeks of physical therapy at home, King began a cardiac rehabilitation program in the Smidt Heart Institute at Cedars-Sinai. Three days a week for three months, she exercised under the guidance of physicians and nurses while hooked up to monitors that displayed her heart rate and rhythm.

King, who projects an upbeat positivity, felt a kinship with other patients who did cardiac rehab.

“I remember talking to one woman who kept saying she was so happy to see that even after you have surgery, you can still go about life and be happy,” she said.

King is grateful that ACFC had medical experts available to resuscitate her. Cedars-Sinai is the team's official healthcare partner, and health system physicians regularly care for players and sit on the sidelines at games.

Zaslow, a sports medicine physician, said that because not all sports teams have access to doctors, it is important that adults, especially coaches, know how to perform CPR.

“In this case, we had trained personnel ready to respond, but what if something like this happens somewhere else, like a kid's soccer field or even an airport?” she said.

Recent imaging shows King’s new artery pathway is feeding her heart as it should. She’s back to working out alongside her teammates and hopeful to be playing competitively again soon.

“I had to trust the process and know that everything I'm doing is for the greater purpose of being on the field again,” she said. “Having love, support, and prayers from not just my family and friends but nationwide has really helped me get to the other side of this.”

Read More Link: Can Exercise Make You Sharper and Happier?

Although cardiovascular disease is a leading cause of death for women, they remain underrepresented in clinical trials for common heart conditions. These findings, by investigators in the Smidt Heart Institute at Cedars-Sinai, were presented at the 2025 European Society of Cardiology Congress in Madrid.

“Numbers don’t lie,” said Martha Gulati, MD, director of Preventive Cardiology in the Smidt Heart Institute and senior author of the paper. “We hope that keeping track of male-to-female participant ratios will motivate researchers to design trials that reflect the real-world population.”

Gulati presented the findings in an oral abstract at the European Society of Cardiology Congress. The results were simultaneously published in JAMA Network Open.

Gulati and colleagues reviewed data from 1,079 cardiovascular clinical trials registered on ClinicalTrials.gov from 2017 to 2023. Women accounted for 41% of the study participants. Investigators found the proportion of women included in clinical trials for certain conditions was much lower than the proportion of women who have these conditions.

The team applied a ratio called the participation-to-prevalence ratio (PPR) to capture whether the percentage of women in a clinical trial reflected how common the condition is among women. The participation-to-prevalence ratios for women were lowest for trials of coronary heart disease, acute coronary syndrome and stroke. Research on obesity and pulmonary hypertension had much higher female participation.

Investigators also found that younger women, ages 19 to 55, were more likely to participate in clinical trials than women 61 or older, and that women tended to enroll in trials studying lifestyle interventions and not trials studying procedures.

“Some studies might stop enrolling once they reach a certain number of people,” Gulati said. “It would be more equitable to continue enrolling until the number of women in the study reflects the proportion of women with that condition.”

The authors also recommend researchers improve outreach efforts to female patients.

“Although we’ve made progress, critical gaps persist,” said study co-author Susan Cheng, MD, MPH, the Erika J. Glazer Chair in Women’s Cardiovascular Health and Population Science in the Smidt Heart Institute. “It’s important to ensure that what we learn from research can be applied to women, who represent more than half of the world’s population.”

Frederick Berro Rivera, MD, is first author of the study. Other authors include John Vincent Magalong, MD; Nathan Ross B. Bantayan, BSc; Nicole Tesoro, MD; Mark Jason Milan, MD; Vikramjit Purewal, DO; Polyn Luz S. Pine, MD, MBA; Chieh-Mei Tsai, MD; Ann Marie Navar, MD, PhD; Sharon L. Mulvagh, MD; James Januzzi, MD; C. Michael Gibson, MD; Anuradha Lala-Trindade, MD; Kyla Lara-Breitinger, MD; and Mayra Guerrero, MD.

Funding: This work was supported by contracts from the National Heart, Lung, and Blood Institutes, General Clinical Research Center, National Center for Advancing Translational Sciences, Department of Defense, Gustavus and Louis Pfeiffer Research Foundation, Women’s Guild of Cedars-Sinai Medical Center, Ladies Hospital Aid Society of Western Pennsylvania, QMED, Edythe L. Broad and the Constance Austin Women’s Heart Research Fellowships (Cedars-Sinai Medical Center), Barbra Streisand Women’s Cardiovascular Research and Education Program (Cedars-Sinai Medical Center), Society for Women’s Health Research, Linda Joy Pollin Women’s Heart Health Program, Erika Glazer Women’s Heart Health Project, Adelson Family Foundation (Cedars-Sinai Medical Center), Robert A. Winn Diversity in Clinical Trials Career Development Award, and the Anita Dann Friedman Endowment in Women’s Cardiovascular Medicine & Research.

Read more on the Cedars-Sinai Blog: Why Diversity Matters in Clinical Trials

At first, Chris noticed he’d be out of breath while carrying equipment during his son’s Little League games. Eventually the lack of oxygen made it difficult to move and caused his thoughts to blur. His doctors said he desperately needed another transplant, but surgeons at 15 centers had rejected his case, saying it was too complex.

It was October 2023 when Chris and wife Liz prepared to call the Smidt Heart Institute at Cedars-Sinai after meeting with the lung transplant team there. They braced for another compassionate—but emphatic—no. Instead, what they heard was that the team would take his case.

“They were willing to give me more time with my family,” Chris, now 48, said.

Chris and Liz gathered their kids in the living room and they hugged as they shared the news. The family would be temporarily relocating to Los Angeles to begin the process of getting Chris on the organ transplant list.

“When you read his story on paper, you can be taken aback by what's a very risky endeavor,” said Dominick Megna, MD, surgical director of the Lung Transplant Program at Cedars-Sinai. “When you actually meet Chris, you see something totally different. You see a guy who's willing to fight, who has resilience and drive in him and a loving wife willing to support him.”

When Liz met Chris in high school Spanish class, she thought he was funny. Soon they were going to the movies together and talking on the phone for hours.

Chris told Liz not to fall in love with him. That’s because at 8 days old, Chris had been diagnosed with cystic fibrosis, a disease that causes the lungs to create an excess of thick, sticky mucus that clogs airways.

“I warned her it’d be a life of doctors’ appointments,” Chris said.

They dated anyway, often hanging out with friends and family in their Houston suburb, and Liz would visit Chris during his frequent hospitalizations.

“He's always been an incredibly generous, authentic and intelligent person,” Liz said. “I knew from a young age that he was the person I wanted to spend my life with.”

They married when Liz was 20 and Chris 22. After many difficult conversations, Chris and Liz chose to have children through in vitro fertilization after bloodwork confirmed Liz was not a carrier of the genetic mutations that cause cystic fibrosis. Both parents must carry the altered cystic fibrosis gene for a child to inherit the condition. 

The family eventually moved to Arizona, where the arid climate allowed Chris to breathe easier than the Houston humidity.

Exercise helps keep the lung mucus at bay and Chris was diligent about daily workouts. Despite this, his lungs required constant care, so much so that Liz created a play area in his hospital rooms for their children. When Chris’ condition forced him to leave his job as a physical therapist, he learned to do personal investing from home.

A double lung transplant in 2015 made it possible for Chris to see both of his children finish elementary school, his son enter middle school and his daughter start high school.

When those lungs started to lose function because of chronic rejection, Chris knew a second transplant would be more challenging. Scar tissue from previous surgeries can interfere with the reattachment of new organs. Chris also had been diagnosed with superior vena cava syndrome, a condition in which one of the body’s main veins has a blockage and cannot circulate blood properly.

“Because of this syndrome, he had poor venous access and an increase in collateral circulation to his right chest, which would increase his risk of bleeding during surgery,” said Reinaldo Rampolla, MD, medical director of the Lung Transplant Program.

Another complicating factor was that after his first transplant Chris had developed a debilitating condition called post-transplant lymphoproliferative disease, a reaction to the many drugs he took to prevent his body from rejecting the first transplant. Although he had been in remission from the disease, physicians were aware that he was at risk.

By the time a donor match was made for Chris in March 2024, he had already been intubated because he couldn’t breathe on his own. Megna and transplant surgeon Pedro Catarino, MD, working with a team of other surgeons, anesthesiologists, surgical technicians and operating room nurses, dissected scar tissue and prepared Chris’ blood vessels to attach to the new lungs. A heart-lung machine called ECMO, or extracorporeal membrane oxygenation, kept Chris alive during the eight-hour operation. Chris became one of 88 patients who received a lung transplant at Cedars-Sinai in 2024.

Today, he’s back in Arizona, lifting weights five days a week, playing baseball with his 13-year-old son, and helping his 16-year-old daughter prepare for college.

“We expect Chris to have a great long-term outcome,” Megna said.

Rampolla is treating Chris with low doses of immunosuppressive drugs to avoid the toxicity that made him sick after his first transplant. Chris travels to Cedars-Sinai for checkups every three months, but these visits will be less frequent as he adapts to his new organs.

Improved surgical techniques and immunotherapy treatments are making it possible for more people to qualify for a transplant. But more than 100,000 people are waiting for an organ in the United States, according to the United Network for Organ Sharing.

Liz gives talks in her community about signing up to be an organ donor. “It’s a horrible thing to think about, but it can be comforting knowing that if something terrible happens to you, you could give life to someone else,” she said.

For Chris, his goals keep changing. He once hoped to be well enough to walk his daughter into kindergarten. He currently looks forward to seeing both children finish college and begin their adult lives.

“Organ donation means everything,” Chris said. “If someone hadn't been generous enough to donate their lungs, my children would have grown up fatherless a long time ago.”

Read more from the Cedars-Sinai Blog: 7 Myths About Organ Donation

That’s what she’s been doing since she was 22, when she was diagnosed with dilated cardiomyopathy, a rare disease that causes the heart muscle to weaken and, eventually, stop pumping blood.

After college graduation, Epps-Manuel began her career in special education. She grew up with a brother with special needs, and Epps-Manuel believed she had found her calling. But one day in 2010, during her first job as a teaching assistant, she came home feeling like she had just run a marathon. She couldn’t catch her breath. An emergency physician discovered her heart was enlarged, and the next day, a cardiologist diagnosed Epps-Manuel with dilated cardiomyopathy.

Just three years earlier, the former intramural college volleyball player had given birth to a healthy boy, and she had never had health issues. No one in her family was known to have a heart condition.

Epps-Manuel’s type of dilated cardiomyopathy is idiopathic, meaning the cause is unknown.

“It was very hard mentally,” she said. “I started having issues with palpitations and had to start wearing an external defibrillator. It was just one thing after another.”

To give herself more flexibility, Epps-Manuel left her elementary school job, moved in with her parents and started a ministry and service center for people with cognitive disabilities.

A few years after she was diagnosed, surgeons at Baylor University Medical Center in Texas implanted a left ventricular assist device (LVAD) to help Epps-Manuel’s heart pump blood. Less than two years later, she received a second LVAD after the first one caused a major blood clot in the cannula of the device’s pump.

In December 2014, Epps-Manuel received a long-awaited heart transplant in Texas, which was followed by difficulties. Medications she took to keep her body from rejecting her new heart so severely injured a kidney that she had to undergo a kidney transplant in 2022. Ten years after the heart transplant, her heart also started to fail. That’s when her Texas doctors referred her to the Smidt Heart Institute at Cedars-Sinai. Tyler Gunn, MD, assistant professor of Cardiac Surgery, led the team of physicians, nurses and operating room staff who performed the transplant.

“When I first met Destany in April 2024 she was very sick, but she was physically fit and had a lot of life ahead of her,” Gunn said.

Epps-Manuel’s case pushed the limits of what surgeons can do.

“With each additional redo surgery, different parts of the heart, tissues and bone fuse together and it becomes much more technically challenging to operate,” Gunn said. “These surgical considerations are why centers from across the nation refer their most difficult cases to Cedars-Sinai.”

Although Epps-Manuel has spent much of her adult life facing life-or-death situations, waiting for her second heart transplant made her feel especially hopeless. She credits the support program led by Rebecca Hedrick, MD, director of Consultation Liaison Services in the Department of Psychiatry and Behavioral Neurosciences, with helping her through her sickest period. The program taught her coping tactics such meditation and helped her use virtual reality to calm her mind. 

“You have to feel your feelings, but you can't stay there,” she said. “You have to have a mindset to fight.”

Epps-Manuel’s second heart transplant took place in October 2024 during a nine-hour operation at the Smidt Heart Institute. A life-support machine called cardiopulmonary bypass temporarily did the work of Epps-Manuel’s heart and lungs. It took surgeons two hours to carefully dissect the bands of scar tissue around the old heart and remove it, a process that typically takes 30 minutes.

Another challenge the Smidt Heart Institute faced was that Epps-Manuel had developed antibodies to the first transplant, so there was a high risk that any future donor heart would be quickly rejected.

Jon Kobashigawa, MD, director of the Heart Transplant Program at Cedars-Sinai and a world expert in preventing and treating organ rejection, managed Epps-Manuel’s care pre- and post- transplant. He created an aggressive immunotherapy plan to stop her body from rejecting the new heart.

Epps-Manuel and her mother lived in Los Angeles for months while she waited for her transplant and recovered afterward. She missed being able to tour colleges with her son, but she is now healthy enough to travel back and forth between her home in Cedar Hill, Texas, and Cedars-Sinai, where she continues to receive desensitization therapy for donor antibodies. She’s excited to volunteer with her ministry again and watch her son compete in senior-year football and track.

“Destany has an incredible, upbeat attitude, which contributes to her recovery,” Kobashigawa said. “She is a joy to care for and continues to inspire our collective team.”

Read more on the Cedars-Sinai Blog--Heart Disease: When to Get a Second Opinion

“Rather than have this hanging over us while thinking of rebuilding, I decided I wanted to be operating at an optimum physical level,” Booher, 45, said. “My husband and I looked at each other and said, ‘This is tragic, but it doesn’t change the immediate plan. We’ll move on to the next step.’”

Booher and husband, Steve, along with their three greyhounds, evacuated their home on Jan. 7. He didn’t have time to pack the collection of comic books he has written. The next day, they learned the house was gone. By Jan. 9, Booher was at the Smidt Heart Institute at Cedars-Sinai for surgery to repair one of his heart’s valves.  

A few months prior, Booher had been diagnosed with mitral valve regurgitation, a condition in which the heart’s mitral valve doesn’t close as it should. Mitral valve regurgitation can cause heart failure, strokes and even sudden death, but it often goes unnoticed because symptoms are subtle. Booher’s fatigue, which he chalked up to his active lifestyle, was one such overlooked sign.

Joanna Chikwe, MD, chair of the Department of Cardiac Surgery at Cedars-Sinai, spent last Wednesday reassuring patients who were watching the Sunset fire from the hospital’s windows that they were in the safest place to be.

“I called patients already scheduled to have open-heart surgery to see what they wanted,” she said. “When I saw David’s address I thought, ‘He’ll never want to proceed. He must be overwhelmed.’ But I was astonished and inspired by his resolve. He told me, ‘Let’s fix my heart so I can rebuild my life.’”

Chikwe repaired the faulty heart valve through a tiny incision with the help of a robot, and Booher, recuperating at a friend’s home a few days later, already feels transformed.

“It boggles my mind that they went into my heart, repaired my valve, and now I feel so healthy,” he said. “The change has been remarkable. I feel like my heart is working efficiently. I feel clearheaded.”

Booher is coming to terms with not being able to go back to a community he loves. Altadena is a special place for him, a mix of architecture, mom-and-pop shops and tight-knit neighbors. He and his husband plan to spend time at their cabin in Big Bear where he’ll continue to write.

“Emotionally, it is starting to sink in,” he said. “When I was in the hospital, I was recovering, so I didn’t have the chance to internalize what happened. I have an incredible support system as I am working through my grief of losing everything. I’m grateful our dogs are safe, we are safe and have a place to stay. And I’m grateful for a healthy heart. That’s what we have to hold on to.”

 Read more on the Cedars-Sinai Blog: Treatment Options for Heart Valve Disease

The U.S. Food and Drug Administration recently approved the new stent, a metal mesh tube that keeps blood vessels open, for use in newborns, infants and children who have narrowing in the aorta or pulmonary artery. Because the stent expands, it is meant to save these children from additional surgeries as they age and need a larger stent for their growing bodies.  

“This approval represents a monumental shift in the way we care for babies with congenital heart disease,” said Evan Zahn, MD, who helped develop the new stent and is director of the Pediatric Congenital Heart Program at Guerin Children’s and in the Department of Cardiology in the Smidt Heart Institute. “It is a joy to know how many patients and families will be positively impacted now that the stent is more widely available.”

Cedars-Sinai is one of the few hospitals in the U.S. where interventional cardiologists are trained in deploying the stent and where children who need it can get that specialized care.

About 40,000 babies are born with a heart defect every year in the United States, according to the U.S. Centers for Disease Control and Prevention. Many of these children have narrowing in the aorta, the artery that carries blood from the heart to the rest of the body, or in the pulmonary artery, which carries blood from the heart to the lungs.

The FDA approved the first-ever stent in 1994, but for adults. Since then, the only option for babies with narrowing has been to resize an adult stent to fit their tiny vessels and replace the stent multiple times as their bodies grow.

“The stents we have had up to this point have had a fixed maximum diameter, meaning that baby is going to need to get it replaced, typically through open-heart surgery,” Zahn said.

To place the stent, an interventional cardiologist makes a tiny hole in the child’s leg and feeds a long, thin tube called a catheter through the groin and into the narrowed blood vessel. A balloon at the end of the catheter expands the vessel and allows the cardiologist to place the stent.  

Over the past five years, Zahn collaborated with engineers at a company called Renata Medical to develop and study the new stent, known as the Minima Stent System. It is made with a unique cell design that allows it to expand to fit a child’s growing body. The expansion is done during a two-hour catheterization procedure rather than through open-heart surgery. Children are expected to be well enough to go home the day after the procedure.

Cedars-Sinai was one of four medical centers involved in an early feasibility study that contributed to the approval of the new stent. The results of that study, published in May, report that the stent was safely implanted and opened narrowed blood vessels.  

“This is the start of a game changer for scores of children all around the world,” said Eduardo Marbán, MD, PhD, executive director of the Smidt Heart Institute and the Mark S. Siegel Family Foundation Distinguished Chair. “It’s a privilege knowing Cedars-Sinai has been intimately involved in the creation of this device.”

Disclosure: Evan Zahn, MD, is chief medical officer of Renata Medical, the company that makes the Minima Stent.

Read more on the Cedars-Sinai Newsroom: Making Strides in Treating the Smallest Heart Patients

The findings, published in Cell, could help scientists develop interventions that repair damaged intestines.

“This study moves forward our knowledge about how the villi, the long and narrow microscopic protrusions that line the small intestine, are first formed,” said Ophir Klein, MD, PhD, executive vice dean of Children’s Health at Cedars-Sinai, executive director of Guerin Children’s and co-corresponding author of the study.

“Understanding villi creation in detail could lead to new treatments for digestive disorders,” said Klein, who is also the David and Meredith Kaplan Distinguished Chair in Children’s Health.

Villi help the body absorb nutrients. They can become damaged by autoimmune disorders, such as celiac disease, or as a result of radiation or chemotherapy to treat cancer.

This study involved a collaboration between scientists working with Klein at Guerin Children’s and with Zev Gartner, PhD, at UCSF. Investigators at the California Institute of Technology and University of Michigan also contributed to the study.

The research teams used high-resolution microscopic techniques to observe how fetal intestines form in laboratory mice, which build their villi similarly to how humans create villi.

The investigators grew intestinal tissue from mouse embryos in laboratory dishes to see in real time how cells began constructing villi. The researchers labeled cell populations with fluorescent proteins to observe which ones were involved in building tissue.

By doing so, they discovered that fibroblasts, a type of connective tissue cell, behave like a sheet of water that breaks up into droplets. They describe this mechanism, which under a microscope looks like rain on a windshield, as “dewetting.” Using a mathematical model, the investigators found that cells follow the same physical principles as water to form droplet-like cellular aggregates that fold tissue into villi.

“Some people have atrophied villi that are blunted or completely flattened due to disease or damage, causing malabsorption and other digestive disorders,” said Tyler Huycke, PhD, a postdoctoral scholar in the School of Pharmacy at UCSF and one of the three co-first authors of the study. “If we can induce cells to undergo this aggregation and tissue-folding behavior that we observe during normal development, we might be able to create more villi and more absorptive surface area for people with digestive disease.”

The investigators plan to study additional steps involved in villi creation, including learning how the tissues continue to elongate into their final form and the cell signaling involved.

“The mechanism we describe in this paper is used by cells to create a patterned curvature in tissues that eventually form villi,” said Gartner, a professor in the Department of Pharmaceutical Chemistry at UCSF and co-corresponding author of the study. “We seek to understand if this mechanism forms other parts of the body. This work lays the foundation for engineering functional human tissues for applications ranging from regenerative medicine to disease modeling and drug testing.”

Cedars-Sinai investigators Emilie Barruet, Dedeepya Vaka and Dario Boffelli also worked on the study. Other investigators include Teemu Häkkinen, Hikaru Miyazaki, Vasudha Srivastava, Emilie Barruet, Christopher McGinnis, Ali Kalantari, Jake Cornwall-Scoones, Qin Zhu, Hyunil Jo, Roger Oria, Valerie Weaver, William DeGrado, Matt Thomson and Krishna Garikipati.

Funding: The study was funded by R01DK126376, R35DE026602, F32DK128949, U01CA244109, R01GM135462, and U01DK103147 from the Intestinal Stem Cell Consortium, a collaborative research project funded by the National Institute of Diabetes and Digestive and Kidney Diseases and the National Institute of Allergy and Infectious Diseases. This work was further supported by funding for the UCSF Center for Cellular Construction by the National Science Foundation.

Read more on the Cedars-Sinai Blog: New Organ-Chip Can Re-Create the Cells of Your Intestines

blood pressure in patients with difficult-to-treat hypertension.

Cedars-Sinai is part of a clinical trial testing the safety and efficacy of the device, which is now commercially available after the U.S. Food and Drug Administration approved it in late 2023.

“This is another tool in our arsenal for patients who have not otherwise been able to control high blood pressure with medication or lifestyle changes,” said Florian Rader, MD, MSc, medical director of the Hypertension Center of Excellence in the Smidt Heart Institute, and the principal investigator of the Cedars-Sinai trial.

For some patients, undergoing this procedure could mean having to take fewer daily medications.

“Patients with treatment-resistant high blood pressure often take upward of four medications to manage their condition,” Rader said. “These patients often can’t control their blood pressure—placing them at significantly higher risk of heart attack, stroke and kidney failure.”     

The device delivers ultrasound energy through the arteries of the kidneys to deaden surrounding nerves that are overactive in many people with hypertension. Research shows that reducing the activity of these nerves can help lower blood pressure.

To deliver the ultrasound energy where it needs to go, an interventional cardiologist threads a narrow, flexible tube called a catheter through an intravenous line from the groin into the aorta and into one of the renal arteries. At the tip of the catheter is an ultrasound transducer that is covered by a water-filled balloon to cool and help protect the lining of the renal artery. The catheter is connected to a generator that powers and controls the ultrasound catheter.

Once the catheter is in place, the cardiologist uses a remote control to send the ultrasound energy through the wall of the renal artery to the surrounding nerves. Each delivery of ultrasound energy lasts a few seconds and is typically done about two to three times in different positions in the same artery. The cardiologist then guides the catheter to the renal artery going into the other kidney and repeats the process. When complete, the cardiologist removes the catheter and intravenous line.

The entire procedure takes about an hour.

“This is a novel way to target a neurobiological process involved in hypertension for which medications are not always effective,” said Suhail Dohad, MD, an interventional cardiologist with the Smidt Heart Institute who has performed the procedure.

Experts at the Smidt Heart Institute focus on personalizing care.

“Patients who come to the Smidt Heart Institute have options, and that is the direct result of our passion for studying new treatments for cardiovascular diseases,” said Christine Albert, MD, MPH, chair of the Department of Cardiology and the Lee and Harold Kapelovitz Distinguished Chair in Cardiology.

Follow Cedars-Sinai Academic Medicine on Twitter for more on the latest basic science and clinical research from Cedars-Sinai.

Read more on the Cedars-Sinai Blog: High Blood Pressure: How to Recognize and Treat It

“Sudden cardiac arrest is a mostly lethal condition, and prevention will make the biggest impact, but we need to find novel clinical tools to make that possible,” said Sumeet Chugh, MD, director of the Division of Artificial Intelligence in Medicine at Cedars-Sinai and senior author of both studies. “Using AI algorithms to improve prediction of sudden cardiac arrest could help doctors identify which patients might be at higher risk of experiencing this devastating condition.”

More than 350,000 people have an out-of-hospital sudden cardiac arrest in the United States every year, according to the Centers for Disease Control and Prevention.

During sudden cardiac arrest, a change in the heart’s electrical activity causes it to suddenly stop beating. Having a heart condition can make a person more likely to experience sudden cardiac arrest, but it also can occur in people with no known heart condition.  

In a study published in Communications Medicine, David Ouyang, MD, assistant professor of Cardiology and Medicine at Cedars-Sinai, along with Chugh and fellow investigators trained a deep learning algorithm to study patterns in electrocardiograms, also known as ECGs, which are recordings of the heart’s electrical activity.

The model studied electrocardiograms from people who experienced sudden cardiac arrest and people who did not. The study included 1,827 pre-cardiac arrest electrocardiograms from 1,796 people who later experienced sudden cardiac arrest. It also included 1,342 electrocardiograms taken from 1,325 people who did not experience sudden cardiac arrest. 

The investigators found the Cedars-Sinai-developed AI model more accurately predicted who would experience out-of-hospital sudden cardiac arrest than did the more conventional method, called the ECG risk score. This is a way for doctors to calculate a person’s risk for sudden cardiac arrest that incorporates information from electrocardiogram readings.

“The entire digital electrocardiogram signal performed significantly better than a few of its components,” said Chugh, who is also the Pauline and Harold Price Chair in Cardiac Electrophysiology Research and associate director in the Smidt Heart Institute. “We plan to continue to study this AI method to learn how it could be used in a clinical setting.”

In another study, published in Circulation: Arrhythmia and Electrophysiology, Chugh along with fellow investigator Piotr Slomka, PhD, director of Innovation in Imaging at Cedars-Sinai and a research scientist in the Division of Artificial Intelligence in Medicine and the Smidt Heart Institute; and other colleagues trained an AI model to differentiate between two underlying causes of sudden cardiac arrest: pulseless electrical activity and ventricular fibrillation.

Pulseless electrical activity means that the heart’s electrical signals are too weak to produce a heartbeat. It cannot be treated with a defibrillator and often leads to death. Ventricular fibrillation is a type of irregular heartbeat that can cause the heart to stop beating, but an electric shock from a defibrillator can trigger the beating again. 

After the AI model reviewed patterns in electrocardiogram readings as well as patient characteristics, investigators were able to determine risk factors for both types of sudden cardiac arrest.

People who had pulseless electrical activity sudden cardiac arrest, for example, were more likely to have been older, been overweight, have had anemia, or experienced shortness of breath as a warning symptom. Those who had ventricular fibrillation were more likely to be younger, have had coronary artery disease or experienced chest pain as a warning symptom.

“We have ways of preventing sudden cardiac arrest through technologies like a defibrillator, but the challenge is knowing who is most likely to benefit from this intervention,” said Lauri Holmstrom, MD, PhD, a visiting postdoctoral scientist at Cedars-Sinai and first author of both studies. “These findings could help cardiologists identify which patients are likely to have a pulseless electrical activity sudden cardiac arrest or ventricular fibrillation sudden cardiac arrest, and help them prevent these events from occurring.”

The AI models used in both studies were trained, tested, and validated using data from two ongoing studies of sudden cardiac arrest founded and led by Chugh: the Oregon Sudden Unexpected Death Study and the Ventura Prediction of Sudden Death in Multi-Ethnic Communities (PRESTO) study.

“These studies exemplify the potential for AI to detect patterns in the body that the human eye and standard medical tests cannot,” said Paul Noble, MD, the Vera and Paul Guerin Family Distinguished Chair in Pulmonary Medicine and chair of the Department of Medicine at Cedars-Sinai, who was not involved in the studies. “We are getting closer to being able to use AI to prevent dangerous events such as sudden cardiac arrest.”

Other Cedars-Sinai investigators who worked on the Communications Medicine study include Harpriya Chugh; Kotoka Nakamura, PhD; Ziana Bhanji; Madison Seifer; Audrey Uy-Evanado, MD; and Kyndaron Reinier, PhD.

Other Cedars-Sinai investigators who worked on the Circulation: Arrhythmia and Electrophysiology study include Bryan Bednarski; Harpriya Chugh; Habiba Aziz; Hoang Nhat Pham, MD; Arayik Sargsyan, MD; Audrey Uy-Evanado, MD; Damini Dey, PhD; and Kyndaron Reinier, PhD.

Funding: Both studies were funded, in part, by the National Heart, Lung, and Blood Institute.

Read more on the Cedars-Sinai Blog: Heart Attack, Cardiac Arrest, Heart Failure—What's the Difference?